儿童医院和社区获得性肺炎大肠埃希菌产ESBLs率和耐药性分析

Drug resistance analysis and ESBLs detection in isolates of E.coli and K. pneumoniae in children with hosptial and community-acquired pneumonia

目的分析医院获得性肺炎(HAP)和社区获得性肺炎(CAP)患儿分离大肠埃希菌产超广谱β-内酰胺酶(ESBLs)检出率和对不同抗菌药物的耐药性。方法分别采用双纸片协同试验和药物敏感试验检测400株大肠埃希菌株产ESBLs检出率和耐药性。结果 HAP患儿分离株产ESBLs率明显高于CAP患儿分离株(P<0.01)。不产ESBLs株对14种抗菌药物耐药率明显低于产ESBLs株。亚胺培南对所有菌株敏感,HAP患儿分离株对其余13种抗菌药物耐药率均高于CAP患儿分离株。结论大肠埃希菌产ESBLs率和对多数抗菌药物耐药率都很高,其中HAP患者更严重;应加强监测,合理使用抗菌药物,减少医院感染。

Objective To analyze the drug resistance and the productive rates of extended-spectrum-β-1actamases （ES- BLs） in E.coli isolates from hospital-acquired pneumonia （HAP） and community-acquired pneumonia （CAP） patients. Methods ESBLs production and resistance to 14 antibiotics of 400 isolates were detected by doubly disk synergy test and drug susceptibility test, respectively. Results ESBLs rate of isolates from HAP was remarkably higher than that of isolates from CAP （P 〈 0.01）. The resistance rates to 14 antibiotics of the ESBLs- isolates were remarkably lower than those of the ESBLs＋ isolates. All isolates were sensitive to imipenem, and the resistance rates to other 13 of the isolates of E.coli from HAP were higher than those of the isolates from CAP. Conclusion High ESBLs rate and resistance rates of majority antibiotics to isolates from HAP and CAP were detected, and there were more serious of HAP. The monitoring and the rational drug application should be strengthened to reduce the nosocomial infection.