临床分离黄杆菌属细菌产β内酰胺酶及耐药性分析

目的　检测黄杆菌的耐药性和产 β内酰胺酶 (BLA)及超广谱 β内酰胺酶 (ESBLs)情况 ,为临床治疗提供理论依据。　方法　将临床分离的 6株黄杆菌属细菌分别以纸片法、双纸片协同法检测其产BLA和ESBLs;用K B法和梯度琼脂平板法检测黄杆菌对抗生素的敏感性 ,测定其最低抑菌浓度 (MIC)。　结果　 6株黄杆菌均为产BLA菌株 ,且 >80 %的黄杆菌产ESBLs;黄杆菌对 β内酰胺类抗生素耐药率高 (MIC为 32 2 5 6mg L),对氟喹诺酮类抗生素及加酶头孢菌素较敏感 (MIC为 0 .12 5 8.0 0 0mg L)。　结论　院内感染的黄杆菌多产BLA,并对BLA类抗生素高度耐药 ;由其导致的感染在治疗上建议优先选用氟喹诺酮类抗生素或加酶抑制剂BLA类抗生素。

Isolation and analysis of the drug resistance of the flavobacterium and its production of β-lactamases

OBJECTIVE: To investigate the drug resistance of flavobacterium and its ability to produce BLA (beta-lactamases) and ESBLs (Extended-spectrum beta-lactamases). METHODS: The production of BLA and ESBLs from 6 clinical isolated flavobacterium strains was determined by nitrocefin disc test and double-disc synergy method, respectively. The antibiotic susceptibilities of the strains were determined by Kirby-Bauer disc diffusion test and the agar dilution method and the MIC was assessed. RESULTS: All the six flavobacteria were BLA-producing strains and more than 80% of them were ESBLs-producing, and they were highly resistant to beta-lactamase antibiotics (MIC 32 - 256 mg/L), but susceptible to fluoroquinolones and cephalosporin with beta-lactamase inhibitors (MIC 0.125 - 8 mg/L). CONCLUSION: Most of the flavobacteria in nosocomial infections were beta-lactamase-producing and were highly resistant to beta-lactamase antibiotics. Fluoroquinolones and beta-lactamase antibiotics with lactamase inhibitors should be the first choice for the management of infection caused by flavobacterium.