产超广谱β-内酰胺酶肺炎克雷伯菌的检测及耐药性变迁

目的 了解肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)的感染现状及其耐药变迁。 方法 收集中山市中医院2011年1月-2014年12月间分离出的2 171株肺炎克雷伯菌进行鉴定和药敏试验,应用WHONET5.6软件进行耐药性分析。 结果 2 171株肺炎克雷伯菌中,其中产ESBLs株564株,占25.98％;药敏结果显示产ESBLs菌株的耐药率普遍高于不产ESBLs株,产ESBLs菌株对碳青霉烯类未见耐药菌株,对头孢唑啉的耐药率高达99.11%。产ESBLs菌株呈多重耐药。 结论 产ESBLs肺炎克雷伯菌的耐药现象严重,及时监测产ESBLs菌株的发生率及其耐药趋势,采取积极应对措施,应根据不同耐药特点合理使用抗菌药物,以延缓细菌耐药性的产生。

Detection and drug resistance of Mycobacterium tuberculosis in Pingyuan County, 2009-2014

Objective To investigate the detection rate and drug resistance of Mycobacterium tuberculosis (M. tuberculosis) in Pingyuan County, Guangdong Province during 2009-2014. Methods We collected 1,682 sputum samples from patients with tuberculosis (TB) or suspected TB patients in Pingyuan County, Gungdong Province during 2009-2014. The samples were dyed with anti-acid staining, and M. tuberculosis was cultured in L-J medium. Susceptibility testing of isoniazid, rifampin, ethambutol and streptomycin was performed.Results A total of 191 M. tuberculosis strains were isolated, including 166 strains from initial treatment patients and 25 from retreatment patients. The total resistance rate was 35.1%. The rates of resistance to 4 drugs were 19.8%, 25.7%, 7.3% and 18.3% respectively. The multidrug resistance rates of strains from initial treatment and retreatment patients were 22.9% and 48.0% respectively, with a statistically significant difference (P<0.05). Conclusions The situation of drug resistance in TB patients in Pingyuan County is serious; and hence, it is necessary to enhance the monitoring and detection of drug resistance and use the drugs rationally.