产超广谱β-内酰胺酶菌的检测方法及耐药性的比较

The detection and drug-resistant comparation of extended-spectrum β-lactamases(ESBLs)

【目的】比较 3种方法检测产超广谱β -内酰胺酶 (ESBLs)菌株的检出率 ,了解近期广东省人民医院大肠埃希菌和肺炎克雷伯菌产ESBLs菌株的感染率及其耐药情况。【方法】walkaway - 4 0机鉴定菌种 ,MIC初筛 ,双纸片协同试验 ,确证试验、药敏纸片扩散法。【结果】大肠埃希菌 72株和肺炎克雷伯菌 78株 ,确证试验检出率分别为 4 6 %和 33%。上述产ESBLs菌株对三代头孢菌素和氨曲南大多耐药 ,对氨苄西林 ,环丙沙星多呈耐药 ,亚胺培南 10 0 %敏感 ,对 5种复方制剂耐药率为 18 2 %～ 10 0 %。【结论】双纸片协同法和NCCLS确证试验均是检测ESBLs的好方法 ,各实验室应重视ESBLs菌株的检测和药敏试验。

To compare the detection rate of three methods for detection of extended-specturm β-lactamases(ESBLs)-producing strains and to study the injecting rate and drug-resistant condition of ESBLs-producing E.coli and Klebsiella pneumomiae at the GuangDong Province′s Hospital.(Walkaway-40 type automatic bacterial identification/drug susceptibility analyzer)MIC Primary screening test.Double paper synergistic test.NCCLS validation test,K-B drug susceptibility paper diffusion test.The results showed that among 72 strains of E.Coli and 78 strains of Klebsiella pneumomiae,there were 46% and 33% detection rate detected by double paper synergistic test and NCCLS vali dationtest.Among ESBLs positive strains of E.Coli and Klebsiella pneumomiae,Most of them showed drug-resistant to cephal or sporins Ⅲ,Aztreonam,Ampicillin and Ciprofloxacin.most of them showed sensitive(100%) to imipenem and drug-resistant(18.2%～100%) to antibiotic-CO.[Conclusion]Double paper synergistic test and NCCLS vali dation test are very nice methods for detecting ESBLs.Each laboratory should appreciate the detection of ESBLs strains and drug susceptibility test.