对产AmpC酶、超广谱β-内酰胺酶的细菌耐药性调查

目的:了解临床产AmpC酶、超广谱β-内酰胺酶(ESBLs)的细菌检出率及其耐药性,以指导临床合理用药。方法:菌株鉴定采用法国梅里埃公司API系列产品,采用改良三维试验方法,分别进行AmpC酶、ESBLs酶测定。根据产AmpC酶,ESBLs酶细菌检测结果与病历结合,调查产AmpC酶、ESBLs酶的发生情况。结果:400株革兰氏阴性杆菌中检出产AmpC酶15株,产ESBLs酶102株,检出率分别为3.8%和25.5%,产酶菌株对16种抗生素(除亚胺培南全部敏感外)的耐药率均高于平均水平。结论:产AmpC酶,ESBLs酶细菌对大多数常用抗生素耐药率超过50%,对产酶菌株临床经验用药可选用碳青酶烯类抗生素。

The Detection of the AmpC and Extended-Spectrum β-Lactamases and the Analysis of Resistance of the Microorganism

Objective:To investigate ESBLs,AmpC-producing microorganism positive rute and drug resistance in order to be taken as a guide in clinical application.Methods:Bacteria was indentified by API series reagents,ESBLs and AmpC were detected by improved three dimensional test.Results:There were 117 isolates of ESBLs and AmpC-producing Gram-negative bacilli in 400 strains,positive rates of AmpC and ESBLs was 3.8% and 25.5% respectively.The resistant rate of the ESBLs and AmpC to 16 kinds of antibiotics was higher than the average.Conclusions:Resistance rate of AmpC,ESBLs-producing microorganism to most antibiotics is more than 50%.Carbopenems can be chosen as clinical experiential medication.