常见革兰阴性杆菌高活性β-内酰胺酶的检测

目的　通过对常见革兰阴性杆菌进行ESBLs和高产AmpC酶的检测 ,了解其在临床的检出率 ,以指导临床用药。方法　用改良的酶提取物三维试验方法进行持续高产AmpC酶和ESBLs的检测 ,并用此法与双纸片扩散法进行比较。 结果　在常见革兰阴性杆菌中高产AmpC酶分别为阴沟肠杆菌 2 0 4%,鲍曼不动杆菌 16.7%,弗劳地枸橼酸杆菌 10 0 %,铜绿假单胞菌 8.6%,肺炎克雷伯菌 7 1%,大肠埃希菌4 4%;ESBLs的检出率分别为肺炎克雷伯菌 2 8 6%,大肠埃希菌 2 7 9%,阴沟肠杆菌 18 4%,鲍曼不动杆菌 13 3 %,铜绿假单胞菌 8 6%。对同时产两类酶的菌株双纸片扩散法检测ESBLs可出现假阴性。结论　对革兰阴性杆菌可使用改良的三维法同时进行ESBLs和高产Am pC酶的检测 ,双纸片扩散法检测ESBLs可应用于所有革兰阴性杆菌的检测 ,但应注意有假阴性 ,特别是对于多重耐药的菌株

The Detection of Beta-lactamses of Gram-negative Rods

Objective To direct utilize clinical drugs by detection ESBLs and AmpC enzymes of the Gram negaive rods.Methods ESBLs and AmpC enzymes were detected with mend three dimensional tests,and compared mend tbree dimensional tests with the double disk diffusion method (DDM).Results There was same positive rate between using three dimensional tests and DDM for detecting the ESBLs enzymes.But there was fake negative using DDM for detecting the ESBLs AmpC enzymes.Three dimensional tests showed the prevalence of the AmpC enzyInes of E.cloacae was 20.4%,A.baumoniae was 16.7%,C.freundii was 10.0%,P.aeruginosa was 8.6%,K.penumoniae was 7.1%,E.coli was 4.1%.The prevalence of the ESBLs of K.penumoniae was 28.6%,E.coli was 27.9%,E.cloacas was 18.4%,A.baumoniae was 13.3%,P.aeruinosa was 8.6%.Conclusion ESBLs and AmpC enzymes of the Gram negative rods clinic were deected with mend three dimensional tests.ESBLs were detected with DDM,but there is fake negative for strain of drug resistant.