头孢噻肟在恶性血液病合并感染患者体内杀菌效价及临床疗效比较

目的 对比观察头孢噻肟（CTX）与其他两种抗菌药物治疗方案对30例血液病合并感染患杀菌活性（SBA）及临床疗效。方法 SBA采用微量稀释法测定，临床疗效根据临床治疗登记表按三级标准判定。结果与结论 头孢噻肟的临床反应最佳，杀菌作用时间维持较长，但对绿脓假单胞菌和阴沟肠杆菌杀菌作用较差；呱拉西林（PIP）与阿米卡星（AN）方案的抗菌谱广，但PIP杀菌作用时间较短，可考虑缩短给药间期，而AN可按一日一次给全日量的方案，以提高疗效减少不良反应；头孢哌酮（CPZ）可主要用于绿脓假单胞菌感染，也可用于其它细菌的混合感染，但给药间隔时间以一日三次为宜。     

外科手术病人奈替米星两种给药方案的比较

目的：通过测定奈替米星（ＮＴＭ）两种给药方案的体内抗菌活性（ＳＢＡ）及血药浓度，观察不同给药方案的疗效与不良反应。方法：血药浓度用ＴＤｘ（荧光偏振免疫法）测定。体内杀菌活性用微量稀释法测定。结果：日剂量相同时，ＮＴＭｑｄ给药，谷浓度均低于２μｇ／ｍｌ，且较ｂｉｄ给药有显著性降低（Ｐ〈０．０５），而其峰浓度较ｂｉｄ给药有显著性增高（Ｐ〈０．０１），除绿脓假单胞菌外，ＮＴＭ对其他３种菌峰时ＳＢＡ均≥１     

14种抗菌药物对铜绿假单胞菌的抗生素后效应

目的：研究１４ 种抗菌药物对医院内感染常见致病菌－ 铜绿假单胞菌的抗生素后效应（ＰＡＥ） 。方法：采用ＡＶＡＮＴＡＧＥ微生物分析仪的吸光度法测定ＰＡＥ。结果：碳青霉烯类对铜绿假单胞菌的抗菌作用较强,ＰＡＥ较长;氟喹诺酮类抗菌药物的ＰＡＥ很长,可达２ ～４ ｈ,呈显著的浓度依赖性;氨基糖苷类对铜绿假单胞菌有一定的ＰＡＥ,而青霉素类、头孢菌素类和磷霉素对铜绿假单胞菌ＰＡＥ则较短。结论：碳青霉烯类、氟喹诺酮类和氨基糖苷类对铜绿假单胞菌的ＰＡＥ较长,临床在设计给药方案时应重视ＰＡＥ因素。     

舒巴克坦对头孢哌酮体外抗生素后效应的影响

目的 考察合用β-内酰胺酶抑制剂舒巴克坦（ＳＢＴ）前后头孢哌酮（ＣＰＺ）对４种致病菌抗生素后效应（ＰＡＥ）的变化。方法 采用特异性β-内酰胺酶鉴定试剂Ｎｉｔｒｏｃｅｆｉｎ挑选大肠埃希氏杆菌、金黄色葡萄球菌、变形杆菌和绿脓假单胞菌的产酶菌株，用比浊法测定受试菌株在不同ＣＰＺ浓度时的ＰＡＥ值。结果 合用ＳＢＴ后，ＣＰＺ对产酶菌株的ＰＡＥ均有不同程度的延长，低浓度时（１／２，１倍ＭＩＣ）ＰＡＥ增加更明显（Ｐ＜０．０５）。结论 合并ＣＰＺ和ＳＢＴ的给药方案对治疗产β-内酰胺酶菌株引起的感染有利，尤其在体内药物浓度较低时，合并用药可以更长时间地抑制细菌生长。     

联用抗菌药物对铜绿假单胞菌的抗生素后效应

铜绿假单胞菌是最常见的病原菌之一,其对多种用于治疗危及生命的感染性疾病的药物耐药已成为临床医生经常面临的难题。联合用药一般用于提供更好的疗效和防止耐药性的出现。严重性铜绿假单胞菌感染常常需要多药治疗,一般采用氨基糖苷类抗生素、β－内酷胺类抗生素和／或喹诺酮类药物联合。Ｓｏｏｄ等通过对３种抗菌药物（阿米卡星·头孢他啶,环丙沙星）单用和联用对铜绿假单胞菌的最低抑菌浓度（ＭＩＣ）和抗生素后效应（ＰＡＥ）的测定,为最佳剂量方案的设计提供理论基础。实验采用５株铜绿假单胞菌临床分离菌株和１株标准菌株（ＡＴＣ…     

奈替米星体内外杀菌活性与给药方案研究

通过测定奈替米星的体内,外杀菌活性及血药浓度,观察不同给药方案的疗效与不良反应,优选其最佳给方案。方法：血药浓度用ＴＤｘ（荧光偏振免疫法）测定。体内,外杀菌活性用微量稀释法测定。结果：ＮＴＭ对常见致病菌有较强的体外抗菌活性。给予ＮＴＭ,ＯＤ给药（ｑｄ）,其谷浓度均低于２μｇ／ｍｌ,较ＴＤ给药（ｂｉｄ）有显著性降低（Ｐ〈０．０５）,而其峰浓度较ＴＤ给药有显著性增高（Ｐ〈０．０１）。除绿脓假单菌外,Ｎ     

22种抗生素对铜绿假单胞菌抑菌浓度研究

用ＡＭＳ法测定了２２种抗生素对铜绿假单胞菌临床菌株的抑菌浓度。ＣＰＬＸ对铜绿假单胞菌的抑菌浓度为０．６４ｍ ｇ／Ｌ,ＴＯＢ、ＩＭＰ、ＧＭ 和ＡＭＫ为１．９５～７．７３ｍｇ／Ｌ,ＣＡＺ、ＡＺ、ＣＰＺ、ＴＣ、ＰＩＰＣ、ＣＴＸ、ＣＥＺ、ＣＸＭ－Ｓ、ＣＸＭ－Ａ、ＣＥＴ和ＡＢＰＣ为９．４１～３２．００ｍｇ／Ｌ,ＣＦＸ、ＴＩＰＣ、ＴＩＰＣ／ＣＡ、ＭＺＰＣ和ＣＢＰＣ为３３．９８～１００．３０ｍ ｇ／Ｌ,ＮＦＴ为１９３．００ｍ ｇ／Ｌ。在不同标本的分离菌中,痰液与伤口、痰液与粪便和伤口与尿液有４种抗生素、痰液与尿液和伤口与粪便有５ 种抗生素、粪便与尿液有１１ 种抗生素的抑菌浓度有显著性差异（Ｐ＜０．０５０～０．００１）。     

基于PK/PD模型结合蒙特卡洛模拟评价3种抗菌药物对铜绿假单胞菌感染延长输注给药方案

目的： 应用PK/PD模型结合蒙特卡洛模拟评价3种抗菌药物对铜绿假单胞菌感染的延长输注给药方案。方法： 收集广州市中西医结合医院2020年铜绿假单胞菌对头孢他啶、哌拉西林钠他唑巴坦（8∶1）、美罗培南的药敏报告,制订3种抗菌药物的3 h延长输注及两步法延长输注共12种给药方案,根据各抗菌药物的药动学/药效学（PK/PD）模型参数,应用蒙特卡洛模拟（Monte Carlo simulation,MCS）计算3种抗菌药物不同给药方案对10 000例感染患者的达标概率（probability of target attainment,PTA）及累积反应分数（cumulative fraction of response,CFR）,对各延长输注给药方案进行评价及临床验证。结果： 临床标本共分离出296株铜绿假单胞菌,经MCS模拟3种抗菌药物所有延长输注给药方案的CFR均小于90%,CFR最高的为哌拉西林钠他唑巴坦2.25 g/0.5 h+2.25 g/3 h q6h给药方案（88.10%）;哌拉西林钠他唑巴坦、美罗培南比头孢他啶对MIC中介的铜绿假单胞菌有更高的PTA及CFR,其中美罗培南1 g/0.5 h+1 g/3 h q8h给药方案对MIC=8 μg·mL^-1的耐药铜绿假单胞菌仍有一定的PTA （60.21%）;临床病例验证与MCS结果相仿。结论： 该院铜绿假单胞菌中介/耐药率较高,针对MIC中介以上的铜绿假单胞菌感染,可选择哌拉西林钠他唑巴坦或美罗培南,通过增加给药剂量、频次并使用两步法延长输注给药方式优化抗感染方案。     

β－内酰胺类抗生素联合舒巴坦对产酶大肠杆菌的体外抗菌活性研究

４种β－内酰胺类抗生素与舒巴坦（ＳＢＴ）以２：１比例联合对临床分离产酶大肠杆菌的体外抗菌活性研究结果表明：氨苄西林（ＡＭＰＣ）、哌拉西林（ＰＩＰＣ）、头孢唑林（ＣＥＺ）、头孢哌酮（ＣＰＺ）联合舒巴坦对４５株产酶大肠杆菌的体外抗菌活性均优于抗生素自身的抗菌活性，尤以ＡＭＰＣ／ＳＢＴ、ＰＩＰＣ／ＳＢＴ、ＣＥＺ／ＳＢＴ明显；８０％以上的产酶株对ＰＩＰＣ／ＳＢＴ、ＣＥＺ／ＳＢＴ、ＣＰＺ／ＳＢＴ和ＣＰＺ敏感；ＣＰＺ／ＳＢＴ与ＣＰＺ的抗菌活性比较差异不明显，可能与ＣＰＺ具有酶稳定性有关。     

临床药师参与1例耐多药铜绿假单胞菌感染患者会诊的药学实践

目的：为耐多药铜绿假单胞菌感染患者的抗菌药物合理应用提供参考。方法：分析1例耐多药铜绿假单胞菌感染患者的抗感染方案,结合痰培养、药敏试验结果及抗菌药物的药理学特性,临床药师建议用药方案为亚胺培南/西司他丁钠（1 g、ivgtt、q6h）＋盐酸莫西沙星氯化钠注射液（0.4 g、ivgtt、qd）二联抗感染治疗。结果：患者的感染症状得到有效控制。结论：临床药师参与耐多药铜绿假单胞菌感染患者的临床会诊,可帮助临床医师解决药物治疗难题,提高治疗水平,保证药物治疗的有效、安全、经济和合理。     

Laboratory and clinical studies on cefoperazone in pediatrics treatment (author's transl)

Laboratory and clinical studies of cefoperazone (CPZ), a new semisynthetic cephalosporin, were investigated and following results were obtained. (1) Blood level: CPZ was given intravenous dose of 25 mg/kg and 50 mg/kg to each 3 children. In the former, the blood level of 15 minutes after injection was 194.2 mcg/ml on average and the half life was 106.2 minutes. In the latter, the blood level was 320.0 mcg/ml on average and half life was 102.2 minutes. (2) Urinary concentration: In the cases of the dose of 25 mg/kg, 35.9% of CPZ was recovered on average from the urine within 6 hours after injection, and the urinary concentration reached to 2,148.6 mcg/ml (0 approximately 2 hours). And in the cases of the dose of 50 mcg/kg, the recovery rate in urine was 43.6%, and the urinary concentration was 3,008.3 mcg/ml. (3) Cerebrospinal fluid level: CSF level was determined in a patient with bacterial meningitis by S. pneumoniae. Ninety mg/kg of CPZ were given intravenous injection. After 60 minutes CSF level was 3.35 mcg/ml, and after 80 minutes the blood level was 192.0 mcg/ml. (4) Bacteriological evaluation: Against 164 strains isolated clinical specimens, the bacteriological evaluation on CPZ was performed in comparison with cefotaxime (CTX), cefazolin (CEZ) and piperacillin (PIPC) by inoculum size of 10(8) cells/ml. CPZ showed antibacterial activity against Gram-negative bacteria almost similar to CTX and PIPC. (5) Clinical results: CPZ was given 48.3 approximately 360 mg/kg/day (average 146.1 mg/kg/day) by intravenous route to 46 patients with various infection. The overall efficacy rate was 80.4%. The rate of bacteriological effectiveness was 78.9% in 19 cases. (6) Side effects: As side effects, diarrhea, fever, rash, urticaria, leukopenia, eosinophilia, elevation of GOT, GPT, and LDH were observed, but not seriously.     

In vitro antimicrobial activity of various antibiotics against Haemophilus influenzae isolated from clinical specimens in 1983

In vitro susceptibilities of 73 strains of Haemophilus influenzae isolated from clinical specimens in 1983 to various antibiotics were studied. The following antibiotics were evaluated; ampicillin (ABPC), piperacillin (PIPC), cefotaxime (CTX), cefoperazone (CPZ), ceftizoxime (CZX), cefmenoxime (CMX), latamoxef (LMOX), tetracycline (TC), doxycycline (DOXY), minocycline (MINO), chloramphenicol (CP) and erythromycin (EM). Susceptible strains to ABPC and PIPC with MICs less than 3 micrograms/ml were 80.3 and 84.1%, respectively. With this break point of MIC, all strains showed susceptibility to CPZ, CZX, and CMX, but resistant strains were observed in 1.5% against CTX and LMOX. Susceptible strains to TC, DOXY and MINO at MICs less than 2 micrograms/ml were 86.3, 80, and 87.7%, respectively. Those to CP at MICs less than or equal to 4 micrograms/ml and to EM at MICs less than or equal to 1 microgram/ml were 86.2 and 71.9%.     

4种抗生素血清和胰液杀菌效价的比较

报道６例行胰管引流病人应用４种抗生素后的血清杀菌效价（ＳＢＡ）和胰液杀菌效价（ＰＢＡ）。结果：头孢哌酮（ＣＰＺ）的ＳＢＡ和ＰＢＡ最高，哌拉西林（Ｐｉｐ）较高；头孢唑林（ＣＺ）对金黄色葡萄球菌的ＳＢＡ和ＰＢＡ较高；对肠杆菌科细菌作用较弱；氨苄西林（Ａｍｐ）的ＰＢＡ低于治疗水平。提示ＣＰＺ和Ｐｉｐ可能为治疗胰腺感染最有效的药物。     

Antibiotic susceptibility of bacteria isolated from surgical infections (first report)

In vitro activities of several antimicrobial agents against bacterial pathogens isolated from patients with primary and postoperative infections were investigated in 1982 and 1983. Antimicrobial agents examined were as follows: sulbenicillin (SBPC), piperacillin (PIPC), cephalothin (CET), cefazolin (CEZ), cefmetazole (CMZ), cefotiam (CTM), cefoperazone (CPZ), cefotaxime (CTX), ceftizoxime (CZX), cefmenoxime (CMX), latamoxef (LMOX), lincomycin (LCM), gentamicin (GM) and amikacin (AMK). Specimens for bacterial isolation included plus, fluid drawn by centesis, or bile. Blood samples of septicemia were excluded. The antimicrobial activities of these drugs were determined by the agar plate dilution method of the Japanese Society of Chemotherapy. There were 123 strains obtained in the 1982 survey and 252 strains in the 1983 survey. Little or no differences were seen in frequencies of isolation between the isolates of principal species in 1982 and those in 1983. Isolation frequencies of pathogens in primary infections were, in an order of decreasing frequency, E. coli (25.6%), anaerobes (21.1%), Streptococcus sp. (14.3%), Staphylococcus sp. (11.3%); in postoperative infections, Streptococcus sp. was most frequent (28.6%), followed by Pseudomonas sp. (17.6%), anaerobes (12.6%), E. coli (10.9%), Staphylococcus (10.1%). Against S. aureus, CEZ, CTM, LCM and GM had similar degree of activity with CET being somewhat more active. CMX was the most active drug among the third generation cephems tested against S. aureus. No strain was CTM, CEZ, and LCM-resistant at the same time. Over 90% of E. coli, were sensitive to CTX, CZX and CMX, inhibited by 0.10 microgram/ml, while E. coli were slightly less susceptible to CPZ and LMOX. Penicillins were not very active against K. pneumoniae, and only 60% of K. pneumoniae were inhibited by PIPC at concentrations of 12.5 micrograms/ml. Third generation cephems, CTX, CMX and CZX, proved highly active against K. pneumoniae; over 90% of K. pneumoniae was inhibited by CTX, CMX and CZX at a concentration of 0.10 microgram/ml. About 60% of P. aeruginosa was inhibited by 3.13 micrograms/ml of PIPC and GM but was resistant to SBPC. This survey should be very useful for the selection of an appropriate drug for prophylaxis if the frequencies of incidences of pathogens in postoperative infections are taken into account in selecting the most active antibiotic agent(s) against the most frequent genus, genera and species of pathogens.     

肛周脓肿感染肠杆菌科细菌分布及药敏试验结果分析

目的通过对肛周脓肿患者感染肠杆菌科细菌的分布情况及其药敏分析,为临床合理使用抗生素提供依据。方法选取大理白族自治州中医医院2016年1月至2018年12月收治的638例肛周脓肿的患者作为研究对象,分析肛周脓肿穿刺液培养检出肠杆菌科细菌的结果。结果557株肠杆菌科细菌中大肠埃希菌464株(83.3%),产超广谱β-内酰胺酶157株(33.8%);其次是肺炎克雷伯菌54株(9.69%),产超广谱β-内酰胺酶1株(1.9%);奇异变形杆菌18株(3.23%),产超广谱β-内酰胺酶1株(5.6%)。大肠埃希菌敏感率大于80.0%的抗菌药物有阿米卡星、厄他培南、美罗培南、头孢他啶、头孢西丁、头孢哌酮/舒巴坦、亚胺培南、哌拉西林/三唑巴坦。肺炎克雷伯菌敏感率大于80.00%的抗菌药物有阿米卡星、阿莫西林/克拉维酸、氨曲南、厄他培南、环丙沙星、氯霉素、美罗培南、庆大霉素、替卡西林/克拉维酸、头孢他啶、头孢西丁、头孢呋辛、头孢吡肟、头孢哌酮、头孢哌酮/舒巴坦、头孢噻肟、妥布霉素、亚胺培南、左氧氟沙星、哌拉西林/三唑巴坦。奇异变形杆菌敏感率大于80.0%的抗菌药物有阿米卡星、阿莫西林/克拉维酸、厄他培南、氯霉素、美罗培南、庆大霉素、替卡西林/克拉维酸、头孢哌酮/舒巴坦、亚胺培南、哌拉西林/三唑巴坦、氨苄西林/舒巴坦。结论治疗大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌引起的肛周脓肿,经验使用抗菌药时,可选用头孢他啶、头孢西丁、阿米卡星,对于存在多重耐药菌感染高风险的患者,需考虑产超广谱β-内酰胺酶细菌感染可能,可选用头孢哌酮/舒巴坦、哌拉西林/三唑巴坦,重症感染时首选亚胺培南、美罗培南进行抗感染治疗。     

Therapeutic effects of cefpirome, a new cephalosporin, on various models of infections in mice and rats

Cefpirome (HR 810) is a new cephalosporin with a 2,3-cyclopentenopyridine group in the 3-position side chain. It was compared with other cephem antibiotics in protective and therapeutic effects on various experimental infections, systemic and local, in mice and rats. HR 810 had more potent protective effect than ceftazidime (CAZ), cefoperazone (CPZ), and cefotaxime (CTX) on systemic infections induced by Escherichia coli Ec-31, Staphylococcus aureus SMITH, and Serratia marcescens Sm-6 in mice. Against systemic infection with Pseudomonas aeruginosa HR 810 was as effective as CAZ. Mice with leukopenia induced by cyclophosphamide were systemically infected with methicillin-resistant S. aureus (MRSA), methicillin-susceptible S. aureus (MSSA), Enterobacter cloacae, Acinetobacter calcoaceticus, and Enterococcus faecalis. HR 810 was superior to cefuzonam (CZON) and cefmetazole against MRSA and MSSA and was much more active than any other antibiotics tested against E. cloacae and A. calcoaceticus. In the activity against E. faecalis, HR 810 was inferior to ampicillin but superior to CZON. In mice with pyelonephritis caused by E. coli Ec-7, the rank order of activities was HR 810 greater than CAZ greater than CTX greater than CPZ. HR 810 was more effective than latamoxef, CAZ, CTX, and CPZ in improving lung infections induced by Streptococcus pneumoniae HL 438 and Klebsiella pneumoniae Kp-51 in mice. HR 810 was superior to CTX and CPZ and comparable to cefazolin in therapeutic effects on intrauterine infections with E. coli Ec-89 and S. aureus SMITH in rats.     

替加环素与临床常用抗菌药物对碳青霉烯类耐药肠杆菌科细菌的协同作用研究

目的评价替加环素与临床常用抗菌药物对碳青霉烯类耐药肠杆菌科细菌(CRE)的协同作用。方法收集2014—2016年临床分离的非重复CRE共235株。琼脂稀释法进行药物敏感性试验并分析替加环素和9种常用抗菌药物的耐药率。选取替加环素非敏感的35株作为研究对象,并采用棋盘稀释法检测替加环素联合其他9种抗菌药物(亚胺培南、美罗培南、头孢他啶、头孢噻肟、氨曲南、左氧氟沙星、阿米卡星、哌拉西林/三唑巴坦和头孢哌酮/舒巴坦)对CRE的协同作用。结果肺炎克雷伯菌、沙雷菌属、产气肠杆菌、阴沟肠杆菌对替加环素的耐药率较高,分别是5.1%(7/137)、5.6%(1/18)、7.7%(1/13)和8.3%(1/12)。替加环素与头孢他啶、哌拉西林/三唑巴坦联合效果最明显,协同百分比都是28.6%(10/35)。替加环素与头孢噻肟(9/35,25.7%)、左氧氟沙星(8/35,22.9%)和头孢哌酮/舒巴坦(7/35,20.0%)也显示出较好的协同作用。研究中未出现药物拮抗的作用。结论替加环素与头孢他啶、哌拉西林/三唑巴坦联合对CRE的协同作用比较明显。替加环素的联合治疗可能比单用更为有效。     

老年下呼吸道院内感染细菌耐药性分析

目的通过对老年下呼吸道院内感染细菌耐药性的分析，为临床合理使用抗生素提供依据。方法对下呼吸道院内感染的患者中分离出来的细菌，以珠海黑马生物工程有限公司做微生物分析系统BACT-TST稀释法做药敏试验。以美国临床实验室标准委员会（NCCLS）2002年推荐的表型确认试验检测超广谱β-内酰胺酶（ESBLs）。结果老年医院获得性肺炎（Hospital acquired pneumoniae HAP）和社区获得性肺炎（Community acquired pneumoniae CAP）细菌对16种抗生素的耐药率分别为：青霉素95．2％和90、8％，哌拉西林80％和76％，头孢噻肟钠39．5％和35．6％，西力欣46．2％和42．3％，头孢哌酮40％和30％．阿米卡星48．6％和42．8％，环丙沙星56％和51．6％，左氧氟沙星50％和41．7％，头孢哌酮／舒巴坦3．5％和1．23％．阿莫西林／克拉维酸钾10．5％和6．7％，哌拉西林／他唑巴坦2．2％和1．03％，氨苄西林／舒巴坦3．8％和2．36％，头孢他定16．7％和11．7％，头孢曲松14．6％和10.2％，亚胺培南0，万古霉素0。其中亚胺培南，万古霉素，头孢哌酮／舒巴坦。哌拉西林／他唑巴坦对产生ESBLs耐药率最低，分别是0、0、0、5.8％。结论老年下呼吸道院内感染细菌耐药性和ESBLs检出率均显著高于院外感染者，亚胺培南、头孢哌酮／舒巴坦、哌拉西林／他唑巴坦、万古霉素是治疗产ESBLs菌株感染引起的有效抗生素。     

Antibacterial activities of new cephems against clinically isolated organisms (author's transl)

The antibacterial activities of cefotaxime (CTX), cefoperazone (CPZ), ceftizoxime (CZX), cefmenoxime (CMX), latamoxef (LMOX), cefotiam (CTM), cefazolin (CEZ), gentamicin (GM) and cefsulodin (CFS) were investigated. All causative organisms were isolated from patients with urinary tract infections treated in Tokai University Hospital. The results were as follows. 1) The MICs of CMX, CTX, and CZX against most of clinically isolated strains of E. coli, K. pneumoniae, Indole (-) Proteus sp. were 0.1 microgram/ml and lower. And then CTM, LMOX and CPZ showed similar antibacterial activities. 2) LMOX and GM showed potent antibacterial activities against C. freundii which was considered to be causative organisms of infections in rare cases. 3) Against S. marcescens, CMX, CTX, CZX, and LMOX showed very potent antibacterial activities. 4) Against P. aeruginosa, CFS, GM and CPZ showed moderate antibacterial activities. 5) Against Enterobacter sp., GM and CMX showed potent antibacterial activities.     

557株大肠埃希菌耐药性分析

目的:了解大肠埃希菌产超广谱β-内酰胺酶(ESBLs)及对常用抗菌药物的耐药情况,为临床抗感染治疗提供用药依据。方法:采用头孢他啶与头孢他啶加克拉维酸、头孢噻肟与头孢噻肟加克拉维酸的双纸片确证试验检测ESBLs,采用纸片扩散法(K-B法)检测大肠埃希菌对常用抗菌药物的耐药性。结果:2007、2008、2009年产ESBLs大肠埃希菌的检出率分别为35.9%、43.7%、46.9%。大肠埃希菌对常用抗菌药物的耐药率以头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、呋喃妥因、阿米卡星较低,其余抗菌药物的耐药率在52%以上。结论:我院大肠埃希菌的耐药形势严峻。加强抗菌药物临床应用管理,是提高细菌感染治愈率和控制院内感染、降低细菌耐药性的重要手段。