摘要
目的 了解本地区革兰阴性 (G- )菌超广谱 β-内酰胺酶 (ESBL s)的产生情况及其临床分布 ,指导临床医生合理使用抗生素 ,防止医院感染及产 ESBL s细菌的暴发流行。方法 用 Micro Scan W/ A- 4 0细菌分析系统对分离菌株进行鉴定 ,用纸片扩散法对分离的 G-菌进行 ESBL s确证试验。结果 在所有 4 36株 G-菌中 ,ESBL s总的检出率为 17.2 % ,主要见于大肠埃希菌 2 7.9%、肺炎克雷伯菌 2 5 .7%、阴沟肠杆菌 11.9%、产酸克雷伯菌8.3% ;各病区 ESBL s细菌的检出率以重症监护病房 (ICU)最高 (2 7.4 % ) ,其次为呼吸科病房 (2 2 .7% )和肾内科病房 (18.3% ) ;在各种标本中 ESBL s的检出率以痰标本最高 ,其次为尿液标本 ;ESBL s细菌对亚胺培南的敏感率最高 (10 0 % ) ,其次为哌拉西林 /他唑巴坦。结论 ESBL s总的检出率为 17.2 % ,以大肠埃希菌为主 ;重症监护病房、呼吸科病房是 ESBL s细菌的高发病房 ;ESBL s细菌广泛耐药 ,其治疗以亚胺培南为首选 ,其次为大剂量的哌拉西林 /他唑巴坦。
OBJECTIVE To study the inducibility and distrubution of bacteria which produced extended spectrum beta lactamases (ESBLs), and to instruct rational application of antibiotics. METHODS Gram negative bacilli were tested by MicroScan W/A 40 and the confirm test for detecting ESBLs used standard plate. RESULTS The detection rate of ESBLs producing bacteria among total 436 Gram negative bacilli was l7.2%, including Escherichia coli 27.9%, Klebsiella pneumoniae 25.7%, Enterobacter cloacae 11.9%, K. oxytoca 8.3%. The bacteria which produced ESBLs were isolated from ICU (27.4%) or respiratory ward (22.7%), nephrolgy ward (18.3%) . The main source where ESBLs bacteria isolated were sputum and urine. To ESBLs bacteria imipenem (IPM) and piperacillin/tazobactam (P/T) were susceptive. CONCLUSIONS The detection rate of ESBLs producing bacteria was l7.2%, among them E.coli was more common than others. They were mainly isolated from ICU and respiratory ward, and mostly susceptible to IPM and P/T.
出处
《中华医院感染学杂志》
CAS
CSCD
2003年第7期681-683,共3页
Chinese Journal of Nosocomiology
关键词
超广谱Β-内酰胺酶
纸片扩散法
医院感染
Extended spectrum beta lactamases (ESBLs)
Plate dilution method
Nosocomial infections