肺炎克雷伯菌和大肠埃希菌对11种抗生素的耐药监测

Resistant rates of 930 clinical strains of Klebsielia pnenmoniae and Escherichia coli to 11 antibiotics

目的:监测肺炎克雷伯菌和大肠埃希菌对11种抗生索的耐药率,为合理选用抗生素提供依据。方法:收集1999年3月～1999年10月上海地区4家医院临床标本中分离出的肺炎克雷伯菌和大肠埃希菌共930株,用Kitby-Bauer琼脂扩散法检测细菌药敏情况;用头孢硝噻吩纸片测定β-内酰胺酶。结累:在11种抗生素中总耐药率最低的前三位是亚胺培南(0.11%)、头孢美唑(6.31%)和头孢他啶(22.26%),耐药率最高的是环丙沙星(49.57%)和头孢呋新(42.47%),其中环丙沙星对大肠埃希菌的耐药率高达68.88%;除头孢他啶外,第三代头孢菌素对肺炎克雷伯菌和大肠埃希菌的耐药率均在30%以上;肺炎克雷伯菌和大肠埃希菌的总产酶率为84.95%,其中肺炎克雷伯菌为85.98%.大肠埃希菌为83.08%。结论:亚胺培南、头孢美唑和头孢他啶耐药率最低;肺炎克雷伯菌和大肠埃希菌产酶率高,该地区极可能有产超广谱β-内酰胺酶(ESBLs)菌流行。

Objective: To investigate the resistant rates of Klebsiella pneumoniae and Escherichia coli strains to 11 antibiotics. Methods: Kirby-Bauer agar diffusion method was used to judge drug sensitivity. Cefinase paper was used in the β—lactamase property analysis of pathogenic bacteria. Results: In 11 antibiotics, Imipinem, Cefmetazole, and Ceftazidime had the lowest resistant rates of 0.11%, 6.31%, and 22.26%, respectively. Ciprofloxacin and cefuroxime had the highest resistant rates of 49. 57% and 42. 47%, respectively. The resistant rate of Escherichia coli strains to Ciprofloxacin was 68.88%. Except ceftazidime, the resistant rates of Klebsiella pneumoniae and Escherichia coli strains to Oxyimino-β-lactams and monobactams were more than 30%. In 930 pathogenic bacteria, the total zymogenic rate was 84.95%, among which Klebsiella pneumoniae strains was 85.98%, and Escherichia coli strains was 83. 08%. Conclusion: Imipinem, Cefmetazole and Ceftazidime were the most effective agents. The zymogenic rate of Klebsiella pneumoniae and Escherichia coli strains was high. There was probably ESBLs-producing strains in Shanghai.