下呼吸道产超广谱β-内酰胺酶肺炎克雷伯氏菌及大肠埃希氏菌的耐药性分析

目的分析临床分离的下呼吸道产超广谱β-内酰胺酶肺炎克雷伯菌及大肠埃希菌的耐药特点，从而掌握耐药菌株的流行状况。方法按常规方法进行细菌分离、培养和菌种鉴定。采用微量液体稀释与K—B法分别对常用抗生素和头孢哌酮／舒巴坦的耐药性进行检测。结果产ESBLs肺炎克雷伯菌和大肠埃希菌对AMP、AMP／SB、PIP、CF、CFZ、CRM、CPD、CAX、CAZ、CTX、CPE和AZT的耐药率高达90％以上；对含β-内酰胺酶抑制剂的复合制剂（PIP／TB和SCF）的耐药率分别是52．6％、34．6％和39．7％、19．8％；对环丙沙星、庆大霉素、妥布霉素的耐药率较高，分别是64％、88．8％，96．2％、75％和96％、87．9％，具有多重耐药特点，但对亚胺培南敏感。结论产ESBLs肺炎克雷伯菌和大肠埃希菌对多种不同种类抗生素耐药，且具有多重耐药的特点。尤其是对青霉素、头孢菌素类耐药率高，但对碳青霉烯类抗生素敏感。

Detecting drug-resistant bacteria and their genotype of extended-spectrum beta-lactamases in Klebsiella pneumoniae and Escherichia coli

Objective The resistant-drug bacteria and their genotype of ESBLs in K. pneumoniae and E. coli from clinical specimens was detected, which can help us to understand their epidemiological status and the mechanisms of drug-resistant to antibiotics. Method The isolation, cultivation and identification of bacteria were performed by the traditional procedures. Micrudilution and K-B method were applied to detect the resistance of ESBL-producing in K. pneumoniae and Escherichia coli to cefoperazone/sulbactam. Result The resistance rates to common antibiotics were up to 90% in Klebsiella pneumoniae and Escherichia coli, including to AMP, AMP/ SB, PIP, CF, CFZ, C RM, CPD, CAX, CAZ, CTX, CPE and AZT. The resistance rates in the compound （PIP/Tb and SCF） of betalactamases with inhibitor were 52. 6% ,34. 6% and 39.7% ,19. 8%, respectively. The higher resistant rates were found in cinrufloxacin, gentamycin and tobramycin, which accounted for 64%, 88.8% and 96.2%, 75% and 96%, 87.9%, respectively. Furthermore, the resistance was multiple resistant -drug bacteria except for sensitive to imipenem. Therefore, The carbopenems was main antibiotics to bacteria producing ESBLs. Conclusion The resistance rates axe high to lots of common antibiotics in Klebsiella pneumoniae and Escherichia coli, especially to penicillin and cephalosporin except for sensitive to imipenem, the carbopenems were main antibiotics to bacteria-producing ESBLs.