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大肠埃希菌、肺炎克雷伯菌产超广谱β-内酰胺酶菌株的耐药性监测
引用本文:张亚莉,史占军,李中齐,耿穗娜,李琼,汪能平.大肠埃希菌、肺炎克雷伯菌产超广谱β-内酰胺酶菌株的耐药性监测[J].中华医院感染学杂志,2004,14(3):331-333.
作者姓名:张亚莉  史占军  李中齐  耿穗娜  李琼  汪能平
作者单位:第一军医大学附属南方医院,广东,广州,510515
摘    要:目的了解医院临床分离出的产超广谱β-内酰胺酶(ESBLs)的主要细菌,大肠埃希菌和肺炎克雷伯菌中产ESBLs菌株的构成比和耐药特征,为临床抗感染治疗提供参考. 方法 2002年1~12月从本院住院患者的各类临床标本,采用Kirby-Bauer(K-B)琼脂扩散法和ESBLs确证试验进行ESBLs的检测. 结果大肠埃希菌、肺炎克雷伯菌产ESBLs菌株的检出率分别为43.7%和35.3%;产ESBLs菌株较不产ESBLs菌株表现为对抗菌药物明显高的耐药率,除个别抗菌药物外,两者差异具有显著性P值<0.05,以及高多重耐药率;产ESBLs的大肠埃希菌、肺炎克雷伯菌对亚胺培南耐药率最低,分别是4.5%和2.1%,其次是阿米卡星、头孢哌酮/舒巴坦,对其他抗菌药物的耐药率均>70%. 结论产ESBLs菌株感染给临床治疗带来较大困难,遏制产ESBLs菌株的产生,要加强细菌耐药性监测、合理应用抗菌药物.

关 键 词:大肠埃希菌  肺炎克雷伯菌  产超广谱β-内酰胺酶  耐药
文章编号:1005-4529(2004)03-0331-03
修稿时间:2003年8月15日

ESBLs-producing Escherichia coli and Klebsiella pneumoniae:An Antibiotic-resistance Analysis
ZHANG Ya-li,SHI Zhan-jun,LI Zhong-qi,GENG Sui-na,LI Qiong,WANG Neng-ping.ESBLs-producing Escherichia coli and Klebsiella pneumoniae:An Antibiotic-resistance Analysis[J].Chinese Journal of Nosocomiology,2004,14(3):331-333.
Authors:ZHANG Ya-li  SHI Zhan-jun  LI Zhong-qi  GENG Sui-na  LI Qiong  WANG Neng-ping
Abstract:OBJECTIVE To survey the constituent ratio and drug-resistance characteristics of ESBLs-producing bacteria-Escherichia coli and Klebsiella pneumoniae. METHODS Isolation, cultivation, identification, drug-sensitivity tests, and confirmation of ESBLs-producing bacteria were done for all the bacterial specimens collected from our hospital in 2002. Susceptibility testing was performed by disk diffusion (K-B) method. RESULTS The constituent ratios of E.coli and K.pneumoniae, which could produce ESBLs, were 43.7% and 35.3%, respectively at our hospital in 2002. The MDR (multi-drug-resistance) rate of ESBLs-producing strains was higher than that of strains no producing ESBLs (P<0.05). The ESBLs-producing strains of E.coli and K.pneumoniae were sensitive to imipenem, and their resistance rates to imipenem were 4.5% and 2.1%, respectively. The resistance rates of ESBLs-producing E.coli strains to amikacin, cefoperazone/sulbactam (Sulperazon) were 24.6% to 31.4%. The resistance rate of K.pneumoniae strains to Sulperazon was 42.5%, and over 70% to other antibiotics. CONCLUSIONS The high constituent ratio of ESBLs-producing bacteria and high MDR rates make them very tough for clinical treatment of infection, which suggests that it be urgent to reducing the amount of ESBLs-producing bacteria. Wide-spectrum antibiotics should be applied strictly.
Keywords:Escherichia coli  Klebsiella pneumoniae  ESBLs-producing bacteria
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