产ESBLs菌株及其耐药性监测的临床意义

ESBLs-producing strains and the clinical significance of drug resistance monitoring

目的探讨产超广谱β-内酰胺酶(ESBLs)菌株及其耐药性监测的临床意义。方法选取2019年6月至2020年6月本院门诊与住院患者各种临床样本分离的大肠埃希菌与肺炎克雷伯菌共150株,通过琼脂扩散法及ESBLs验证试验开展ESBLs检测。比较大肠埃希菌、肺炎克雷伯菌产ESBLs检出率与产ESBLs菌株对单种抗菌药与多种抗菌药的耐药性。结果150例菌株中产ESBLs检出64株(42.67%),分别从肺炎克雷伯菌、大肠埃希菌检出30、34株。肺炎克雷伯菌、大肠埃希菌产ESBLs菌株对各种抗菌药物的耐受性除亚胺培南、氨苄西林外均高于非产ESBLs菌株(P<0.05)。肺炎克雷伯菌、大肠埃希菌产ESBLs对头孢菌素类、青霉素类联合酶抑制剂具有多重耐药性。结论在肺炎克雷伯菌与大肠埃希菌中产ESBLs菌株均分离率较高,且对除亚胺培南外的抗生素均具有较高耐药性及多重耐药性。

Objective To explore the clinical significance of extended-spectrumβ-lactamase(ESBLs)-producing strains and their drug resistance monitoring.Methods A total of 150 strains of Escherichia coli and Klebsiella pneumoniae isolated from various clinical samples of outpatients and inpatients in our hospital from June 2019 to June 2020 were selected,and ESBLs detection was carried out through the agar diffusion method and ESBLs verification test.The detected rates of ESBLs produced by Escherichia coli and Klebsiella pneumoniae and the resistance of ESBLs producing strains to single and multiple antibacterial drugs were compared.Results 64 cases(42.67%)ESBLs-producing strains were detected in 150 cases strains,30 and 34 strains were detected from Klebsiella pneumoniae and Escherichia coli.The tolerance of Klebsiella pneumoniae and Escherichia coli strains producing ESBLs to various antibacterial drugs were higher than those of non-ESBLs producing strains except imipenem and ampicillin(P<0.05).ESBLs produced by Klebsiella pneumoniae and Escherichia coli have multiple drug resistance to cephalosporins and penicillins combined with enzyme inhibitors.Conclusion Both Klebsiella pneumoniae and Escherichia coli strains producing ESBLs have high isolation rate,and have high drug resistance and multi-drug resistance to antibiotics except imipenem.