双纸片协同试验在检测产超广谱β-内酰胺酶细菌中的临床应用

The Clinical Use of Double-paper Synergy Test in the Detection of Bacteria Producing Extended-spectrum β-lactamase

用双纸片协同试验检测我院近 6个月来临床标本中产 ESBLS的细菌 ,并探讨双纸片协同试验的最佳方法。结果显示 ,在 2 44株大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌中产 ESBLS菌 49株 ,总检出率为 19.6 7% ,另外在嗜麦芽窄食单胞菌检出 5例产 ESBLS株 ,铜绿假单胞菌 ,产气肠杆菌和枸橼酸杆菌各检出 1例产 ESBLS株 ,说明我院产 ESBLS菌株产生较广泛。由于 ESBLS阳性株对临床常用抗生素的耐药率远远高于 ESBLS阴性株 ,使临床治疗面临极大的困难 ,必须引起临床医生和临床微生物室的重视。提示我院双纸片协同试验的最佳底物是 FTX、 ATM和 FEP,最适距离是2 5 mm,该法与 Etest确证试验的阳性符合率为 10 0 % ,因此该法仍为临床微生物室检测 ESBLS的适宜、简便。

The optimal condition of double paper synergy test in the detection of bacteria producing extended spectrum β lactamase (ESBL S ) was studied. In 244 isolates of Enteric bacilli, Klebsiella pneumonia, Enteric cloacae, there were 49 ESBL S producing strains with the positive rate being 19.67 %. Five ESBL S producing strains were detected in Pseudomonas maltophilla. One ESBL S producing strains was detected in Pseudomonas aeruginose, Enteric aerogenes and Citrobacter, respectively. The optimal substrates of double paper synergy test were cefotaxime, aztreonam and cefepime, and the interspace was 25 mm. This method was still a simple, economical and appropriate method in the detection of ESBL S producing isolates.