Occurrence of K1 and K2 serotypes and genotypic characteristics of extended spectrumβ-lactamases-producing Klebsiella pneumoniae isolated from selected hospitals in Malaysia

Objective:To determine the distribution,phenotypic and genetic background of extended spectrumβ-lactamases(ESBL)-producing Klebsiella(K.)pneumoniae clinical isolates associated with K1 and K2 serotypes in two selected hospitals in Malaysia.Methods:A total of 192 K.pneumoniae isolates were collected and subjected to antibiotic susceptibility,hypermucoviscosity test and multiplex PCR to detect the presence of K1-and K2-serotype associated genes.Multilocus sequence typing(MLST)was performed on ESBL-producing K.pneumoniae isolates presented with K1 and K2 serotypes,followed by phylogenetic analysis.Results:A total of 87 out of 192(45.3%)of the K.pneumoniae isolates collected were ESBL producers.However,only 8.3%(16/192)and 10.9%(21/192)of the total isolates were detected to carry K1-and K2-serotype associated genes,respectively.Statistical analysis showed that K1 and K2 capsular serotypes were not significantly associated with ESBL phenotype(P=0.196).However,they were significantly associated with hypervirulent,as demonstrated by the positive string test(P<0.001).MLST analysis revealed that ST23 as the predominant sequence type(ST)in the K1 serotype,while the ST in the K2 serotype is more diverse.Conclusions:Although the occurrence of ESBL-producing isolates among the hypervirulent strains was low,their coexistence warrants the need for continuous surveillance.MLST showed that these isolates were genetically heterogeneous.

Prevalence and characteristics of extended spectrum β-lactamase-producing Escherichia coli from bovine mastitis cases in China

The aim of the study was to investigate the prevalence and characterization of extended-spectrum β-lactamase （ESBL）- producing Escherichia coli isolated from bovine mastitis cases in China. ChromID ESBL agar was used to confirm ESBL-producing E. coli. PCR and DNA sequencing were employed to characterize the genotype of ESBL-producers. Antimicrobial susceptibility was measured by disc diffusion. Overall, 73 of 318 E. coli isolates （22.96％） were identified as ESBL-producers. Of these ESBL-producing E. coli, the prevalence of blaCTX-M and blaTEM-1 was 97.26 and 71.23％, respectively. The predominant CTX-M-type ESBL was CTX-M-15 （65.75％）, followed by CTX-M-14 （10.96％）, CTX-M-55 （9.59％）, CTX-M-64 （5.48％）, CTX-M-65 （4.11％） and CTX-M-3 （1.37％）. This study is the first report of CTX-M-64 and CTX-M-65 in E. coli isolated from bovine mastitis. Furthermore, 72 ESBL-producing E. coli isolates （98.63％） were found to be multidrug-resistance. This study noted high prevalence and rates of antimicrobial resistance of ESBL-producing E. coli isolates from bovine mastitis cases in China.

Appendical Perforation by Infection with Extended-Spectrum Beta-Lactamase (ESBL)-Producing <i>Escherichia coli</i>: Case Report

We report the very rare case of a huge appendical abscess with extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli (E. coli) as the pathogen. There have been several reports of appendical infections such as appendicitis and appendical abscess caused by ESBL-producing bacteria in adults. The treatment of ESBL-producing E. coli infection is specific, and ESBL-producing bacteria have recently been reported as pathogens associated appendicitis in children. To the best of our knowledge, this is the second report of perforated appendicitis with abscess due to ESBL-producing E. coli. We discuss the diagnostic modalities and treatments for appendical abscess with ESBL-producing E. coli. and propose that the patients with perforated appendicitis and abscess formation due to ESBL-producing E. coli should be administered the antibiotic MEPM within 2 weeks to treat the abscess more effec-tively without producing other multidrug-resistant bacteria.

Intestinal carriage of methicillin resistant Staphylococcus aureus and extended-spectrum β-Lactamase-producing Enterobacteriacae in hospitalized and nonhospitalized patients and their clinical implications

Objective:To determine the clinical implication of and intestinal carriage with methicillin resistant Staphylococcus aureus(MRSA) and extended spectrumβ-lactamase(ESBL)-producing Enterobacteriacae.Methods: A total of 180 stool specimens were screened for MRSA and ESBL-producing enterobacteria.Identification of ESBL- producing Enterobacteriacae was done by MicroScan Walk Away 96 system(Dade Behring Inc.,West Sacramento,CA 95691,USA ) and confirmation by double-disc synergy test.MRSA was identified by disc diffusion using 30μg cefoxitin disc and the MicroScan.Results:The rate of fecal MRSA carriage was 7.8% (14/180),35.7%(5 /14) were recovered from surgical wards.Three patients(21,4%) had MRSA recovered from other body sites,and 2(14.2%) had in addition ESBL -producing Escherichia coli(E.coli) and Klebsiella pneumoniae(K.pneumoniae) respectively.Four(28.5%) patients with MRSA fical carriage died. MRSA fecal carriage was recovered from both inpatients and outpatients.Four(2.2%) cases carried ESBL-producing Enterobacteriacae in feces.Three(75%) were from intensive care unit(ICU).One patient had both ESBL-producing E.coli and K.pneumoniae from stool as well as E.coli from tracheal aspirate.Two ICU patients with fecal ESBL died.Conclusion:Fecal screening for MRSA and ESBL of all patients at high risk admitted to different hospital wards and ICUs and implementing infection control measures were recommended.

Multidrug resistance extended spectrum β-lactamase and AmpC producing Escherichia coli isolated from the environment of Bogor Slaughterhouse,Indonesia

To determine the multidrug resistance extended spectrum β-lactamase and AmpC (ESBL/AmpC producing) Escherichia coli (E. coli) isolated from the environment of Bogor slaughterhouse, Indonesia.MethodsA total of 35 samples from 7 locations in slaughterhouse i.e., source of water, slaughtering floor, swab of carcass area floor, swab of evisceration area floor, untreated waste water, treated waste water, drinking water for cattle were collected from March to April 2016. Presence of ESBL/AmpC producing E. coli and susceptibility testing against 8 antimicrobial agents (penicillin G, streptomycin, gentamycin, ciprofloxacin, enrofloxacin, tetracycline, trimethoprim-sulfamethoxazole, and polymyxin B) were detected by disk diffusion test according to Clinical and Laboratory Standards Institute.ResultsESBL/AmpC producing E. coli were identified in 14.3% (5/35) of the collected samples from the environment of Bogor slaughterhouse. ESBL/AmpC-producing E. coli isolates were detected in untreated waste water (n = 3), slaughtering floor (n = 1), and carcass area floor (n = 1). Most of ESBL/AmpC-producing E. coli isolates (80%) showed multidrug resistance phenotypes against at least three classes of antibiotics. The highest incidence of antibiotics resistance was against penicillin G (100.0%) and streptomycin (100.0%), followed by gentamicin (60.0%), trimethoprim-sulfamethoxazole (60.0%), tetracycline (40.0%), ciprofloxacin (40.0%), enrofloxacin (20.0%), and polymyxin B (0.0%).ConclusionsThe transmission of antimicrobial resistant bacteria into the environment may be a potential risk for human health.

Prevalence and Potential Risk Factors of Hospital Acquired Extended-Spectrum Beta-Lactamase—Producing <i>Proteus</i>Species

Background: Multidrug resistance and production of extended spectrum β-lactamases (ESBLs) by a large group of bacterial agents in hospitals are to be a matter of scientific concern. Objective: This cross-sectional study was aimed to investigate the prevalence of ESBL producing Proteus species and risk factors associated with hospital acquired infection in addition to study the antibiotics susceptibility patterns of all bacterial isolates from inpatients of four Yemeni general hospitals. Methods: A total of 740 consecutive non-repeat culture isolates were obtained from admitted patients of Al-Kuwait University Hospital, Al-Thowra General Hospital, Al-Jumhori Teaching Hospital, and Military General Hospitals Sana’a city. We used Kirby-Bauer disk diffusion method to detect antimicrobial susceptibility and establish the presence of ESBLs-producing bacteria according to the Clinical and Laboratory Standards Institute guidelines. Results: Out of 740 isolate, 233 (31.5%) were Escherichia coli followed by Staphylococcus aureus 188 (25.4%), Pseudomonas aeruginosa 149 (20.1%), Klebsiella sp. 107 (14.5%), Enterococcus faecalis 25 (3.4%) and Proteus spp. 38 (5.1%). The highest frequencies of ESBLs producing among Proteus sp. were Proteus mirabilis 26 out 38 (68.4%) and Proteus vulgaris 12 out 38 (31.6%). The most effective of antimicrobial susceptibility pattern among Proteus spp. were Imipenem (100%) followed by Pipracillin-Tazobactam (92.3%) for P. mirabilis and (83.3%) for P. vulgaris, while the Amikacin (80.8%) for P. mirabilis and P. vulgaris with (91.7%). Amoxicillin and Cefotaxime were the highest for both species (100%). Conclusion: The prevalence of ESBL-producing Proteus spp. detected in this study is of great concern for public health authorities and a strict adherence of infection control policies and procedures with continuous antibiotics resistance surveillance including antimicrobial management and routine detection of ESBL-producing isolates are very important to prevent nosocomial infections.

Antimicrobial resistance, genotypic characterization and pulsed-field gel electrophoresis typing of extended spectrum β-lactamases-producing clinical Escherichia coli strains in Macao, China

Background The rise of the production of CTX-M class extended spectrum β-lactamases （ESBLs） has been well documented in traveling countries but no data are found for Macao, an international travel city. The objectives of this study were to identify the antimicrobial resistance pattern, and determine the prevalence, genotype and clonal relationship of ESBLs in 209 clinical Escherichia coli strains from Macao, China. Methods Antimicrobial susceptibility test was performed to determine the resistance patterns of the isolates using the disk diffusion method with 17 antimicrobial agents. Phenotypic detection was screened and confirmed according to the Clinical and Laboratory Standards Institute. Genotypic characterization was detected by isoelectric focusing analysis, polymerase chain reaction and sequencing. The clonal relationship between the different ESBL isolates was studied by pulsed-field gel electrophoresis （PFGE）. Results Imipenem and meropenem exhibited 100% susceptible among 209 strains. Overall, 82.3%, 67.3%, 52.9%, 51.2% and 51.0% of the isolates displayed resistance to ampicillin, tetracylcline, ciprofloxacin, sulfamethoxazole trimethoprin and gentamycin. The prevalence rate of ESBLs was 30.1%. Antibiotic resistances were found to be significantly higher among the ESBL producing group compared to non-ESBL producing group. We detected CTX-M-14 to be the major genotypic characterization of ESBLs （76.2%）. Two strains showed indistinguishable patterns by PFGE. Conclusions The prevalence of antimicrobial resistance is alarming high in Macao. Antimicrobial resistance is significantly higher among the ESBL producing group. This study documented CTX-M-14 as the predominant ESBL type. Although indistinguishable pattern was found between two strains, it was too small to decide whether any of the investigated strains was epidemic. Our findings may be also pertinent for other geographic areas undergoing similar travel characteristics to understand the corresponding effects on bacterial populations.

Phenotypic and genotypic detection of extended-spectrum β-lactamase (ESBL) producing Escherichia coli isolated from urinary tract infections in Zabol,Iran

Objective:To investigate the role of a rapid polymerase chain reaction(PCR)assay in comparison with traditional empiric therapy in detection of extended spectrum β-lactamase(ESBL)producer Escherichia coli(E.coli).Methods:Ninety isolates of E.coli from urinary tract infection were collected and screening of ESBL resistance using disc diffusion method,minimum inhibitory concentration(MIC)for ceftazidime and detection of TEM resistant gene by PCR were done.Results:The results of disc diffusion method showed that forty out of ninety E.coli isolates were ESBLs producing organisms.Antibiotic susceptibility of E.coli isolates to 9 antibacterial agents were evaluated.However,all isolated E.coli were resistant to all 9 antibacterial agents by these percentage:ceftriaxon(100%),ceftazidime(100%),amoxicillin(100%),erythromycin(100%),azithromycin(95%),cefixime(87.5%),tetracyclin(87.5%),nalidixic acid(85%)and difloxcain(75%).The abundance of antibiotic-resistant TEM gene according to PCR was 30%.Totally 82.5%of strains tested by MIC were observed as ceftazidime-resistant.Conclusions:We conclude that the TEM gene PCR assay is a rapid,sensitive and clinically useful test,particularly for the early detection of ESBLs-producing E.coli.

Status of ESBL Producing Bacteria Isolated from Skin Wound at a Tertiary Care Hospital in Bangladesh

Background: ESBL producing bacteria are increasing with an alarming rate with a wide range of infections. Objective: The purpose of the present study was to see the status of ESBL producing bacteria isolated from skin wounds. Methodology: This cross sectional study was conducted in the Department of Microbiology at Mymensingh Medical College, Bangladesh from January 2011 to June 2011 for a period of 6 months. All the patients, at any age with both sexes presented with skin wound infection, were taken as study population. Wound swab was taken from all patients. Specimens were processed and bacteria were isolated and identified according to standard procedure. The ESBL status was confirmed by double disc diffusion test (DDDT) and minimum inhibitory concentration (MIC) by agar dilution method by standard procedure according to Clinical Laboratory Standard Institute (CLSI). Antimicrobial resistance was done by disc diffusion method. Result: A total number of 84 wound swabs were taken of which the most common ESBL producing bacteria were Esch. coli (61.5%),?Proteus species (78.3%) and Klebsiella species (88.9%). All the isolates were sensitive to imipenem and nitrofurantoin followed by amikacin (92.9%). Conclusion: In conclusion, ESBL producing E. coli is the most common bacteria causing skin wound infection followed by Proteus species with a reduced sensitivity towards antibiotics.

Determination of the prevalence of extended spectrum β-lactamase in clinical samples collected from Dehradun City Hospital

Objective:To detect extended spectrumβ-lactamase(ESBL)and determine its prevalence in various clinical samples collected from Dehradun City Hospital.Methods:The samples were first cultured in MacConkey’s agar plates by streak plate method,then identified by Gram staining and biochemical tests.The isolated bacterial strains were then tested for antibiotic susceptibility by Kirby-Bauer method.The ESBL detection is then carried out by double disc diffusion method.Results:Off the 56 samples cultured,21 strains were identified which were six Escherichia coli(E.coli),six Klebsiella,four Proteus,four Pseudomonas aeruginosa(P.aeruginosa)and only one Acinetobacter.Eight out of 21(38.1%)strains including three of E.coli,three of Klebsiella and two of P.aeruginosa,were found to be resistance to all five antibiotics(piperacillin,amikacin,ampicillin,gentamicin,and ciprofloxacin).Initial screening using four antibiotics(cefotaxime,ceftazidime,aztreonam and ceftriaxone)and the final confirmatory test using ceftazidime/clavulanic acid and ceftazidime alone showed that 19.05%of all strains isolated were ESBL producers.Individually,16.67%E.coli,16.67%Klebsiella pneumoniae,25%P.aeruginosa and 100%Acinetobacter were found to be ESBL producers.Conclusions:Antibiotic resistance by ESBL has become a major risk factor worldwide,therefore routine checkup and accordingly prescription are suggested.

产超广谱β-内酰胺酶肠杆菌血流感染患者不良预后危险因素分析

目的通过分析产超广谱β-内酰胺酶肠杆菌(extended-spectrum β-lactamase producing enterobacterales,ESBL-E)血流感染患者不良预后的危险因素,构建列线图预测模型,为临床诊治提供帮助。方法回顾性分析建德市第一人民医院收治的血培养结果为ESBL-E血流感染235例患者的临床资料,根据患者预后分为存活组(n=211)和死亡组(n=24)。采用多因素Logistic回归分析筛选预后不良的独立危险因素,建立列线图并对其进行验证。结果合并休克、呼吸衰竭、糖尿病和白血病、入住重症监护室、低蛋白血症、白细胞计数升高或降低、血小板计数减少的ESBL-E血流感染患者死亡率更高(P<0.05);多因素Logistic回归分析结果表明合并休克、呼吸衰竭、白血病是ESBL-E血流感染患者死亡的独立危险因素。结论通过建立ESBL-E血流感染患者不良预后危险因素的列线图预测模型,为临床医生早期判断患者不良预后提供帮助,早期采取干预措施,降低患者病死率。

下呼吸道感染产超广谱β-内酰胺酶革兰阴性菌耐药性分析及临床意义

目的 分析下呼吸道感染产超广谱 β-内酰胺酶 (ESBL s)革兰阴性菌的产生及对 11种抗菌药物耐药情况 ,并对临床针对性治疗产 ESBL s耐药菌下呼吸道感染提出了建议。方法 采用法国生物 -梅里埃公司生产的 GNS-5 0 6药敏卡及双纸片协同试验法 ,对从临床下呼吸道感染标本中分离出的 16 6株革兰阴性菌作 ESBL s的检测 ,比较亚胺培南等 11种抗菌药物对产 ESBL s耐药菌体外抗菌作用。结果 产 ESBL s耐药株占全部分离菌的2 1.7% ,其中肺炎克雷伯菌占 36 .1% ,大肠埃希菌占 2 7.8% ,阴沟肠杆菌占 2 5 % ,铜绿假单胞菌占 8.3% ;亚胺培南对铜绿假单胞菌外产 ESBL s耐药菌均表现出最强抗菌作用 ;头孢西丁对产 ESBL s肺炎克雷伯菌及大肠埃希菌有较好的抗菌作用 ,其他产 ESBL s耐药菌对头孢西丁呈全部耐药 ;氨基糖苷类及氟喹诺酮类抗菌药物对产ESBL s肺炎克雷伯菌呈现出较好的抗菌作用。结论 产 ESBL s革兰阴性菌所致下呼吸道感染不容忽视 ;对产ESBL s革兰阴性菌下呼吸道感染的治疗 ,亚胺培南可作为首选药物。

救必应中药血清与抗菌药联合对产ESBLs细菌抑菌效果的研究

本试验主要探讨救必应中药血清与抗菌药联合诱导细菌传代的体外抑菌活性。制备救必应中药血清,采用二倍微量稀释法体外检测抗菌药的最小抑菌浓度(MIC),然后救必应中药血清与抗菌药联合诱导产超广谱β-内酰胺酶(extended spectrumβ-lactamases,ESBLs)细菌传代。救必应中药血清与抗菌药联合诱导细菌传代对耐药大肠杆菌有不同程度的抑菌活性。救必应中药血清可明显地增强β-内酰胺类抗菌药、氨基糖苷类抗菌药、喹诺酮类抗菌药和卡巴氧类抗菌药对耐药菌的抑制作用。

2005—2009年肺炎克雷伯菌耐药性变化的分析

目的:了解肺炎克雷伯菌耐药率的变迁。方法:回顾分析2005—2009年692株肺炎克雷伯菌药敏数据,细菌鉴定和药敏实验采用全自动仪器的方法。结果:肺炎克雷伯菌耐药性呈逐年上升趋势;第3代头孢菌素耐药率从2005年的20%左右,上升到2009年的40%左右;氟喹诺酮类药物耐药率从40%左右上升至70%左右;ESBLs分离率从25.6%上升至43.7%;其他抗生素的耐药率也有不同程度的升高。结论:临床过多地经验性地使用第3代头孢菌素和氟喹诺酮类药物是导致肺炎克雷伯菌耐药性迅速增长的主要原因。

产超广谱β-内酰胺酶细菌的检测及耐药性分析

目的 对超广谱β- 内酰胺酶(ESBLs)细菌进行检测,为防止其传播及治疗提供依据。方法 应用纸片扩散确证法检测ESBLs,K B法做药敏试验。结果 在 227株肠杆菌科细菌中检出ESBLs细菌 89株,它们对几乎所有的β- 内酰胺酶类抗生素产生交叉耐药,对氨基糖苷类,喹诺酮类部分耐药,对磺胺类全部耐药,对亚胺培南的敏感率为 100%。结论 产ESBLs细菌具有较高的交叉耐药性,通过耐药质粒可传递给其他细菌,实验室应积极开展ESBLs的检测,并向临床及时报告。

产超广谱β-内酰胺酶大肠埃希菌的分布变迁及临床治疗研究

目的:观察临床分离的产超广谱β-内酰胺酶大肠埃希菌(ESBL-EC)对常用抗菌药物的耐药性变迁情况及药物治疗效果。方法:监测ESBL-EC的耐药趋势并分析临床药物的治疗结果。结果:ESBL-EC对头孢他啶、左氧氟沙星、头孢哌酮舒巴坦、阿米卡星、头孢西丁、哌拉西林他唑巴坦、亚胺培南的平均耐药率分别为64.4%、62.5%、8.7%、9.6%、1.9%、0%、0%;对头孢曲松几乎全部耐药。亚胺培南西司他汀、头孢西丁、头孢哌酮舒巴坦、哌拉西林他唑巴坦对ESBL-EC感染临床治疗效果较好,依替米星治疗效果不佳。结论:临床及时监控ESBL-EC的发生率及其耐药趋势以指导临床用药至关重要。

2010至2011年我院产ESBLs大肠埃希菌的耐药性分析

分析2010年1月至2011年12月牡丹江医学院附属红旗医院临床分离的大肠埃希菌的耐药性变化,为指导临床合理用药提供依据。2010至2011年临床各科室送检的全部标本(包括血、尿、便、痰、分泌物等),采用微生物分析仪进行分离鉴定及药物敏感性分析。2010和2011年产ESBLs大肠埃希菌检出率分别为23.8%5、7.4%,呈上升趋势。产ESBLs大肠埃希菌对大多数抗菌药物的耐药率明显高于非产ESBLs大肠埃希菌(P<0.05)。产ESBLs大肠埃希菌检出率越来越高,耐药率日益严重,给临床抗菌治疗带来很大困难,开展产ESBLs大肠埃希菌耐药性分析,指导临床合理应用抗生素,对控制大肠埃希菌对抗菌药物的耐药性增长有重大意义。

1例产超广谱β-内酰胺酶肺炎克雷伯菌肺炎患儿的抗感染治疗分析

目的:探讨产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌肺炎患儿抗感染治疗方案。方法:临床药师对1例产ESBLs肺炎克雷伯菌肺炎患儿抗感染治疗方案进行分析,寻找疗效不佳的可能原因,优化抗感染治疗方案。结果:医疗机构相关性肺炎(HCAP)患儿经验性抗感染治疗选择头孢哌酮/舒巴坦(68 mg/kg,q 12 h)合理,但给药第5天起降低头孢哌酮/舒巴坦剂量(45mg/kg,q 12 h)可能是导致疗效不佳的主要原因;肺泡灌洗液提示产ESBLs肺炎克雷伯菌感染,临床药师建议更换抗生素为亚胺培南/西司他丁(15 mg/kg,q 6 h),患儿感染得到有效控制,治愈出院。结论:产ESBLs肺炎克雷伯菌感染患儿病情评估为轻中度,可以选择含酶抑制剂的复方制剂,对于有基础疾病的患儿,头孢哌酮/舒巴坦建议选择足量足频次(如50 mg/kg,q 8 h)的给药方案;如患儿病情评估为重度,建议选择碳青霉烯类抗生素,选择碳青霉烯类药物时要考虑不同药物之间疗效和不良反应的差异。

产超广谱β-内酰胺酶细菌致社区感染与医院感染耐药性调查分析

目的探讨产超广谱β-内酰胺酶细菌致社区感染与医院感染耐药性分析,为指导临床合理用药提供依据。方法收集2014年1月～2017年12月检验科细菌培养产ESBLs的大肠埃希菌、肺炎克雷伯菌、奇异变形菌以及产酸克雷伯菌的菌株,在剔除重复菌株后,进行细菌耐药谱调查,并判断是否为医院感染,同时分析社区感染与医院感染的耐药性差异。结果我院2014年1月～2017年12月共检出产ESBLs细菌共647例,社区感染598例,医院感染49例,在对我院社区感染与医院感染的产ESBLs大肠埃希菌耐药率的比较中,发现医院感染的产ESBLs大肠埃希菌对米诺环素、庆大霉素、丁胺卡那霉素、头孢哌酮、头孢西丁以及头孢他啶的耐药性要高于社区感染;医院感染的产ESBLs肺炎克雷伯菌对米诺环素、头孢哌酮、头孢西丁及头孢曲松的耐药性要高于社区感染,并且以上差异均具有统计学意义(P<0.05)。结论院感工作人员应了解医院感染与社区感染的耐药性差异,并将结果及时反馈给临床科室,为临床合理使用抗菌药物提供准确的参考。

产超广谱β-内酰胺酶肺炎克雷伯菌和大肠埃希菌药敏分析

目的了解产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌和大肠埃希菌的分离率及其耐药情况,为临床治疗提供依据。方法收集2007年1月至2009年12月临床送检患者标本分离出的肺炎克雷伯菌和大肠埃希菌,采用常规生化方法和梅里埃API20E系统鉴定、纸片扩散确证试验检测ESBLs,药敏试验采用纸片扩散法。结果 281株大肠埃希菌和174株肺炎克雷伯菌确证试验产ESBLs阳性率分别为36.2%和40.9%,产ESBLs菌对β-内酰胺类抗菌药高度耐药,对阿米卡星、头孢西丁、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿莫西林/克拉维酸、替卡西林/克拉维酸耐药性在5.4%～25.6%,对环丙沙星、复方新诺明和庆大霉素耐药率较高,为65.1%～88.9%,未发现耐亚胺培南产超广谱β-内酰胺酶肺炎克雷伯菌和大肠埃希菌。结论产ESBLs菌的问题日益严重,临床及时了解它们的耐药特点和变化趋势,对合理应用抗菌药物、延缓细菌耐药性的产生,控制播散菌株的流行具有十分重要的意义。