2000年武汉地区产超广谱β-内酰胺酶菌种的分布及药敏分析

目的 了解产超广谱β-内酰胺酶(ESBLs)的细菌分离、分布及对抗生素的敏感性。方法 用APl或V1TEK-AMS系统(Bio’Merieux，法国)鉴定菌种，用NCCLS推荐的初筛和确证法检测产ESBLs的细菌，并用K-B法测定其对14种抗生素的敏感性。结果 2000年武汉地区的269株大肠埃希菌、202株肺炎克雷伯菌、149株阴沟肠杆菌、67株费劳地枸椽酸杆菌、43株产酸克雷伯菌中：ESBLs的检出率分别为40．9％、29．2％、20．1％、29．9％、和23．3％。产ESBLs大肠埃希菌、肺炎克雷伯菌对亚胺培南全部敏感，产ESBLs的大肠埃希菌对阿米卡星的耐药率为22．4％，对其它抗生素有不同程度的耐药。结论 产ESBLs的菌株集中在肠杆菌科菌中，以大肠埃希菌、肺炎克雷伯菌、费劳地枸椽酸杆菌的ESBLs产出最高。阴沟肠杆菌、产酸克雷伯菌ESBLs的产出应引起重视。治疗其感染时应首选亚胺培南。

The distribution and antibiotic susceptibility of producing extended-spectrum beta-lactamases(ESBLs)bacteria in Wuhan area in 2000

Objective To investigate the distribution and antibiotic susceptibility of producing extended spectrum beta-lactamases(ESBLs)bacteria.Methods API or VITEK AMS system were used to identify the bacteria;ESBLs were detected by NCCLS recommended methods and the susceptibilities to 14 kinds of antibiotics were tested by K B method.Results The incidences of ESBLs among 269 strains of Escherichia coli,202 strains of Klebsiella pneumoniae,149 strains of Enterobacter cloacae,67 strains of Citrobacter freundii and 43 strains of K.oxytoca found in Wuhan in 2000 were 40.9%,29.2%,20.1%,29.9%,7.7% and 23.3% respectively.All of the ESBLs producing E.coli and K.pneumoniae were susceptible to imipenem.The resistance rate of ESBLs producing E.coli to Amikacin was 22.4%,while these E.coli were resistant to other antibiotic at different levels.Conclusion The ESBLs producing bacteria mainly belong to Enterobacteriaceae E.coli,K.pneumoniae and C.freundii can produce higher level of ESBLs than others.The ESBLs produced by E.cloacae,K.oxytoca and E.cloacae are serious challenges for the control of infectious diseases.Imipenem is a good choice for the therapy of ESBLs producing bacteria.