某地区分离自呼吸系统感染患者产ESBLs、AmpC酶肠杆菌科细菌耐药性检测

目的 分析肠杆菌科细菌临床分离株产超广谱β-内酰胺酶(ESBLs)和头孢菌素酶(AmpC酶)情况,及其与肠杆菌科细菌耐药性的关系.方法 收集该地区12家医院2009～2010年分离自呼吸系统感染患者呼吸道标本的肠杆菌科细菌1 612株,双纸片增效法检测ESBLs、三维试验检测AmpC酶、K-B纸片法检测菌株耐药性,采用χ2检验进行统计学分析.结果 1 612株细菌中,产ESBLs和AmpC酶菌株检出率分别为45.0%(726/1 612)和11.6%(187/1 612),产酶株对多种抗菌药物的耐药率高于非产酶株;未检出碳青霉烯类抗菌药物耐药菌株.结论 分离自该地区呼吸道感染患者呼吸道标本的产ESBLs和AmpC酶肠杆菌科细菌具有多药耐药性,应加强细菌耐药性监测,采取有效措施防止耐药性的水平传播.

Drug resistance analysis of ESBLs, AmpC enzyme positive Enterobacteriaceae bacteria in patients with respiratory system infection

Objective To investigate the occurrence and distribution of 1 612 isolates of Enterobacteriaceae producing ESBLs and AmpC enzyme to evaluate the multidrug resistance. Methods Double disk synergy method, three dimentional test and Kirby-Bauer test were performed for detection of ESBLs, AmpC and drug resistance respectively. Statistic significance was analyzed by chi-square test.Results ESBLs and AmpC positive rate was 45.0%(726/1 612) and 11.6%(187/1 612) respectively. Strains with enzyme producing was higher resistant to 15 antibiotics than those without enzyme producing (P<0.05). However,imipenem showed good antimicrobial activity among all the strains. Conclusion Respiratory tract infection of ESBLs and AmpC positive Enterobacteriaceae might take important part in multidrug resistance in this area. Surveillance of the integron content of nosocomial Enterobacteriaceae populations should be strengthened to predict and prevent the spread of multidrug resistance.