阴沟肠杆菌去阻遏持续高产AmpC酶和超广谱β-内酰胺酶的耐药调查

Resistance Investigation of Derepressed AmpC Enzyme and Extended-Spectrum β-Lactamases in Enterobacter cloacae

目的 了解阴沟肠杆菌去阻遏持续高产AmpC酶 ,或产超广谱β 内酰胺酶 (ESBLs)及同时表达这两类酶的现状及耐药性 ,指导医生临床用药。方法 采用改良的酶提取物三维试验法 ,检测阴沟肠杆菌去阻遏持续高产AmpC酶 ,用表型确证试验检测ESBLs,并用K B法对抗菌药物进行体外药敏试验。结果 在 6 8株阴沟肠杆菌中 ,8株持续高产AmpC酶 ,14株产ESBLs,3株同时表达这两种酶。结论 产酶菌株对抗菌药物的耐药性远远高于不产酶菌 ,且多重耐药 ,改良的酶提取物三维试验法 ,能较好地检测阴沟肠杆菌持续高产AmpC酶 ,适用于临床常规检验 ,为临床医生使用抗菌药物提供合理建议 。

OBJECTIVE To understand the resistance and the actuality of derepressed hyperproduction AmpC enzyme and/or production of extended-spectrum β-lactamases (ESBLs) in Enterobacter cloacae. METHODS To detect the derepressed hyperproduction AmpC enzyme and production of ESBLs in E. cloacae by the modified three-dimensional extract test and the disk corroborate test. Strains were identified by the susceptibility test. RESULTS Among 68 strains E. cloacae, 8 strains were considered as derepressed hyperproduction AmpC enzyme produced,14 strains were ESBLs produced, 3 strains produced both of them. CONCLUSIONS The resistance of the strains of derepressed hyperproduction AmpC enzyme and ESBLs is serious. The modified three-dimensional extract test could be used to detect the derepressed hyperproduction AmpC enzyme. It is very important to provide correct suggestions to clinical doctors in antibiotics, and to prevent and control the nosocomial infection.