产超广谱β-内酰胺酶肠杆菌科细菌的分离、分布情况及耐药特点研究

Analysis of Isolation,Distribution and Characteristics of Drug Resistance of Producing Extended Spectrumβ-lactamase Enterobacter

目的:探讨产超广谱β-内酰胺酶(ESBLs)肠杆菌科细菌的分离、分布情况及耐药特点。方法:选取2019年1月-2020年1月佳木斯市中心医院感染科送检的各类标本129份,对标本中的细菌进行分离、培养、鉴定,并进行药敏性试验。对产ESBLs肠杆菌的检出率、分布情况进行统计比较,并对药敏结果特点进行综合评估。结果:129份感染标本中,共检出各类菌株145株,其中产ESBLs肠杆菌92株,检出率63.45%,其中产ESBLs大肠埃希菌57株,产ESBLs肺炎克雷伯菌35株。分布情况:产ESBLs大肠埃希菌以引流液为主,科室分布以外科为主;产ESBLs肺炎克雷伯菌以痰液为主,科室以内科为主。耐药性:产ESBLs大肠埃希菌和产ESBLs肺炎克雷伯菌对美罗培南、亚胺培南、阿米卡星、氨曲南、万古霉素等耐药率低,对头孢菌素、青霉素类抗生素高度耐药。结论:在临床感染疾病中产ESBLs肠杆菌有较高的发病率,其中以大肠埃希菌、肺炎克雷伯菌为主,菌株标本来源及科室分布呈现规律性。对青霉素、头孢菌素等多数抗菌药高度耐药,对碳青霉烯类抗生素敏感,临床应根据药敏结果合理选用抗菌药物进行治疗。

Objective:To study the isolation,distribution and drug resistance characteristics of producing extended spectrumβ-lactamase(ESBLs)Enterobacter.Method:A total of 129 specimens of various types submitted for inspection by the Department of Infectious Diseases of our hospital from January 2019 to January 2020 were selected to isolate,culture,and identify bacteria in the specimens,and conduct drug susceptibility tests.The detection rate and distribution of producing ESBLs Enterobacter were statistically compared,and the characteristics of drug susceptibility results were comprehensively evaluated.Result:A total of 145 strains of various strains were detected in 129 infected specimens,of which 92 strains of ESBLs-producing Enterobacter,with a detection rate of 63.45%,of which 57 strains of producing ESBLs Escherichia coli and 35 strains of producing ESBLs Klebsiella pneumoniae.Distribution:producing ESBLs Escherichia coli was dominated by drainage fluid,the distribution of departments was dominated by surgery,producing ESBLs Klebsiella pneumoniae was dominated by sputum,and departments were dominated by internal medicine.Resistance:producing ESBLs Escherichia coli and producing ESBLs Klebsiella pneumoniae had low resistance rates to Meropenem,Imipenem,Amikacin,Aztreonam,Vancomycin,etc.,and high resistant to Cephalosporins and Penicillin antibiotics.Conclusion:Producing ESBLs Enterobacter has a high incidence rate in clinical infectious diseases,among which Escherichia coli and Klebsiella pneumoniae are the main ones,the source of strains and the distribution of the departments show regularity.It is highly resistant to most antibacterial drugs such as Penicillin and Cephalosporin,and is sensitive to carbapenem antibiotics,the clinical application of antibacterial drugs should be based on the results of drug sensitivity.