超广谱β—内酰胺酶检测方法的探讨及临床价值

An Explore and Clinical Significance on the Method of Extended-Spectrun β-Lactamase

目的：本文着重介绍大肠埃希氏菌、肺炎克雷 伯氏菌、产酸克雷伯氏菌的初步筛选试验和表型确认试验；方法：应用纸片扩散法进行初步 筛选试验，对怀疑产酶的菌株用表型确认试验进行确认；结果：从临床上分离出１２５株大肠 埃希氏菌，８２株肺炎克雷伯氏菌，５０株产酸克雷伯氏菌，初步筛选试验筛出９５株怀疑产ＥＳＢＬ ｓ的细菌，其中大肠埃希氏菌４５株，肺炎克雷伯氏菌３３株，产酸克雷伯氏菌１７株。９５株怀疑 产ＥＳＢＬｓ的细菌经表型确认试验测出产酶株共３９株，其中大肠埃希氏菌１７株，肺炎克雷伯氏 菌１４株，产酸克雷伯氏菌８株。在这些细菌中，大肠埃希氏菌的产酶株占１３．５％，肺炎克雷 伯氏菌的产酶株占１７．１％，产酸克雷伯氏菌的产酶株占１６．０％；结论：肺炎克雷伯氏菌和产 酸克雷伯氏菌比大肠埃希氏菌较易产生ＥＳＢＬｓ，ＥＳＢＬｓ的初筛试验和表型确认试验，对指导临 床合理用药具有重要意义。

Objective:We attempted to intruduce the preliminary selecting test and morphology determing test of E.coil、K.pneum oniae、K.oxytoca.Methods:Preliminary selecting test was carried out with Paper.R esults:We studied clinical isolates including 125 of E.coil、82 of K.pneumoniae 、50 of K.oxytoca.95 out of all isolates showed positive in Preliminary selectin g test which were therefore doubted to produce ESBLs,and 45 of 95 isolates were E.coil,33 were pneumoniae,17 were K.oxytoca.39 out of this 95 isolates were test ed positive for producing ESBLs by morphology determing test,in which 17 isolate s were E.coil,14 were pneumoniae,with the percemtage of 13.6%、17.1%、16.0% resp ectively.Conclusion:K.pneumoniae and k.oxytoca tend to produce ESBLs more likely than E.coil,and the preliminary selecting test and morphology determing test pl ay important roles in directing therapy reasonablely,delay the production of bac teria duration and infection.