大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌超广谱β-内酰胺酶的检测及药敏分析

Detection and drug-resistance analysis of Gram-negative bacteriun producing extended-β-lactermases

目的 :了解本院大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌中超广谱 β 内酰胺酶 (ESBLs)细菌的发生率和药敏情况 ,为防止这 3种细菌产ESBLs菌株的传播和抗生素的合理应用提供依据。方法 :细菌鉴定用Vitek 32细菌鉴定仪 ,药敏试验用K B法 ,ESBLs初筛用双纸片法 ,ESBLs确证用NCCLS1999年推荐的确证方法。结果 :产ESBLs耐药菌占全部分离菌的 33 2 % ,其中各细菌ESBLs发生率大肠埃希菌为2 8 6 % ,肺炎克雷伯菌为 34 1% ,阴沟肠杆菌为 4 0 5 %。对实验所做抗生素 ,ESBLs阳性株比阴性株具有更高的耐药率和更严重的交叉耐药现象。结论 :本院大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌ESBLs发生率较高 ,较往年有上升趋势 ,ESBLs菌感染的治疗仍以亚胺培南为首选。

Objective:To determine the prevalence of strains producing extended-spectrum β-lactamases(ESBLs) among Escherichiao coli 、 Klebsiella pneumoniae and Enterobacter cloacae and to investigate the antibiotic resistance of these strains,to provide the evidence for preventing the spread of producing ESBLs and treating it.Methods:Bacteria were detected by Vited-32 system,drug resistance was tested by Kirby-Bauer disk sensitivity mehtod.Bacteria were screened for the presence of ESBLs by double-disk synergy test and confirmed by the method advised by NCCLS 1999.Results:Productive rate of ESBLs in all isolates was 33.2%,and productive rate of ESBLs in Escherichia coli、Klebsiella pneumoniae、Enterobacter cloacae was 28.6%、34.1%、40.5%,respectively.The strains producing ESBLs had higher rate of drug-resistance and multi-cross resistance.Conclusion:In hospital of traditional chinese medcial sciences,the producing rate of ESBLs among Escherichia coli 、 Klebsiella pneumoniae and Enterobacter cloacae was in and increasing tendency. And imipenem could be the frist choice to treat strains producing ESBLs.