合肥市产ESBLs肺炎克雷伯氏菌和大肠埃希氏菌流行状况及耐药性研究

Epidemiological and drug-resistance study on extended-spectrum beta-lactamases producing Klebsiellae pneumoniae and Escherichia coli in Hefei, Anhui Province

目的 调查 1999年 9月至 2 0 0 0年 9月安徽省合肥市产超广谱 β-内酰胺酶 (ESBL s)的肺炎克雷伯氏菌 (KP)和大肠埃希氏菌 (EC)的流行状况及耐药性。方法 收集合肥市四家大医院临床标本分离的 KP和 EC共 2 99株 ,经 ESBL s表型确认试验证实为产 ESBL s细菌 ,用微量肉汤稀释法检测其对 2 0种抗生素耐药性 ,用 K- B法检测其对头孢哌酮 /舒巴坦的耐药性。结果 合肥市 KP和 EC中 ESBL s检出率分别为5 0 .5 %和 2 4.3% ,总检出率为 32 .8%。产 ESBL s菌对头孢他啶、氨曲南、头孢西丁、头孢吡肟、头孢哌酮 /舒巴坦、哌拉西林 /三唑巴坦、阿米卡星及环丙沙星等 2 0种抗生素的耐药率比不产酶株都有不同程度增加 ,但亚胺培南对所有产 ESBL s菌株都敏感。结论 合肥市四家大医院 ESBL s在 KP和 EC中的检出率高。产 ESBL s菌对所测试的 2 0种抗生素的耐药程度比不产酶株为高 。

Objective: To investigate the epidemiological data and drug resistance of extended spectrum beta lactamases (ESBLs) producing Klebsiellae pneumoniae and Escherichia coli in Hefei, Anhui Province between September, 1999 and September, 2000. Methods: 299 clinical isolates of K.pneumoniae and E.coli were collected from four large hospitals in Hefei. ESBLs producing strains were identified by ESBLs phenotype affirmative test. Their resistances to 20 antimicrobial agents were performed by mini broth dilution susceptibility test and to cefoperazone/sulbactam by Kirby Bauer test. Results: The incidences of ESBLs in K.pneumoniae and E.coli were 50.5% and 24.3% respectively. The average incidence was 32.8%. Compared with the resistant rates of non ESBLs producing strains, those of ESBLs producing strains to ceftazidime, aztreonam, cefepime, cefoxitin, piperacillin/tazobactam, cefoperazone/sulbactam, amikacin and ciprofloxacin increased. But all ESBLs producing strains were susceptible to imipenem. Conclusion: Results showed that the incidence of ESBLs was high in K.pneumoniae and E.coli in four large hospitals in Hefei. The resistant rates of ESBLs producing strains against all tested antimicrobial drugs were higher than those of non ESBLs producing strains, while all of the ESBLs producing strains were sensitive to imipenem.