产超广谱β-内酰胺酶大肠埃希菌的耐药谱分析

Producing extended-spectrum beta-lactam enzyme Escherichia coli the drug resistance spectrum analysis

目的:回顾我院2010年9月-2011年11月产超广大谱β-内酰胺酶(ESBLS)大肠杆菌的检出情况以及耐药特点,为临床防控和治疗提供依据。方法:菌株鉴定和药敏试验及ESBLS的确认均采用DL-96E(迪尔生物产品)。结果:共检出1431株大肠杆菌,其中产ESBLS大肠杆菌373株,阳性率为26.1%(373/1431)。药敏结果显示对亚胺培南和美洛培南未见有耐药株,其余耐药率<30%的有哌拉西林/他唑巴坦6.7%,阿米卡星11.5%,头孢哌酮/舒巴坦15.8%,头孢西丁18.6%,呋喃妥因21.2%,而对其他青霉素类、头孢类、硅诺酮类、磺胺都呈现出较高的耐药率。结论:产ESBLS大肠杆菌耐药谱广,治疗选择药物较少,较理想的药物仅有亚胺培南、美罗培南、哌拉西林/他唑巴坦、阿米卡星、头孢哌酮/舒巴坦、头孢西丁、呋喃南妥因,他们可做为治疗的首选或经验用药参考。

Objective： To retrospectively in our hospital from 2010 September - 2011 November production of super broad spectrum beta-lactam enzyme （ ESBLS ） of Eseherichia coli detection and resist- ance characteristics, prevention and treatment to provide the basis for clinical. Method for strain identifi- cation and drug sensitive test and the ESBLS confirmation using DL-96E （ DI biological products ）. Re- sults there were 1431 strains of Escheriehia coli, which produces ESBLS 373 strains of Eseheriehia eoli, the positive rate was 26.1% （ 37a / 1431）. Drug susceptibility results show to imipenem and meropenemhas no resistant strain, the remaining resistance rate 〈30% with piperacillin / tazobactam 6.7%, Amika- cin 11.5%, Cefoperazone / sulbactam 15.8%, cefoxitin 18.6%, furantoyin 21.2%, while on other peni- cillins, X cephalosporins, quinolones, sulfanilamide, all exhibiting a higher resistance rate. Conclusion ES- BLS Escherichia coli drug resistance spectrum is wide, choice of treatment drugs are less, the ideal drug only imipenem, meropenem, piperacillin/ tazohactam, Amikacin, Cefoperazone/ sulhactam, cefoxitin, furantoyin, they can be used as the treatment of choice or experience drug reference.