肺炎克雷伯菌和大肠埃希菌产超广谱β-内酰胺酶及耐药性监测

Detection of extended-spectrum beta-Lactamases in clinical isolates of klebsiella pneumoniae and Escherichia coil and drug resistance

目的 :对本院 2 0 0 1年 7月至 2 0 0 2年 5月收集到的 2 0 0株大肠埃希菌和肺炎克雷伯菌中ESBLS阳性菌进行研究 ,了解超广谱 β -内酰胺酶的三种检测技术及其产ESBLS耐药现状。方法 :对2 0 0株肺炎克雷伯菌和大肠埃希菌用VITEKAMS32测定ESBLS ,同时用美国临床实验室标准化委员会(NCCLS)推荐纸片筛选法和确认法进行对照监测。结果 :仪器法、确认法、纸片筛选法检测ESBLS菌株阳性率分别为 18.97%、18.5 8%、16 .4 1% ,产ESBLS菌对大多数抗生素的耐药率显著高于非产ESBLS菌 ,且多重耐药显著 ,但对泰能均敏感。结论 :ESBLS菌阳性率高 ,耐药性强 ,耐药谱广 。

Objective: Research on ESBLS positive samples in 200 Escherichia coil and Klebsiella pneumoniae that have been collected between July 2001 and May 2002 in the hospital ,Understand three testing techniques of extended spectrum β-lactamases and its ESBLs drug resistance.Methods:Use VITEKAMS32 to test ESBLs in 200 Eschichia coil and Klebsiella pneumoniae.At the same time, use disk selectivity test and ceftaxime/clavulanic acid and ceftaxime compound pieces test that are recommended by NCCLS to carry out comparason tests.Results:These three testing methods on ESBLs are 18.97% ?18.58%? 16.41% , respectively, Antibiotics resistance is higher in ESBLs than in non-ESBLs.Hower, both ESBLs and non-ESBLs are very sensitive to imipenem.Conclusion:ESBLs has high positive-testing rate, strong drug-resistance and wide drug-resistance spectrum.