产超广谱β-内酰胺酶细菌的耐药性研究

目的 了解我院产超广谱β-内酰胺酶(ESBIs)大肠埃希菌和肺炎克雷伯菌对临床常用抗菌药物的耐药情况,为临床治疗和控制ESBLs菌的感染提供依据.方法 采用VITEK全自动微生物分析仪进行细菌鉴定,KB纸片法测定11种抗菌药物的药敏,双纸片协同法检测ESBLs.结果 从2005年1月-2005年12月住院患者送检的标本中分离出大肠埃希菌和肺炎克雷伯菌704株,其中大肠埃希菌282株,肺炎克雷伯菌422株.产ESBLs菌357株,非产ESBLs菌347株,总检出率为50.7%(357/704),其中产ESBLs肺炎克雷伯杆菌211株,检出率为50.0%(211/422),产ESBLs大肠埃希菌146株,检出率为51.77%(146/282).产ESBLs菌与非产ESBLs菌对亚胺培南100%敏感,除大肠埃希菌对哌拉西林胞唑巴坦和头孢哌酮/舒巴坦外,产ESBLs细菌对其他9种抗菌药物的耐药率均明显高于非产ESBLs细菌(P＜0.0236-P＜0.005之间).结论 产ESBLs菌对常用抗菌药物耐药率较高,碳烯霉烯类是治疗产ESBLs菌严重感染的首选药物.

Drug Resistance Analysis on Bacteria of ESBLs-producing

Objective To investigate the antibiotic resistance of ESBLs-producing Escherichia coli and Klebsiella pneumoniae to 11 kinds of antibacterial drugs in our hospital and to provide bases for clinical control and treatment of ESBLs bacteria infection.Methods Bacteria were ideatified by VITEK system and ESBLs-producing strains were detected by doubledisk synergy test.The antibiotic susceptibility of all strains were detected by K-B disk diffusion method.Results 704 strains of Escherichia coli and Klebsiella pneumoniae were collected from different wards in hospital during Jan.2005 to Dec.2005 including 282 strains of Escherichia coli and 422 strains of Klebsiella pneumoniae.A total of 357 strains producing ESBLs were found in 704 strains and the detetion rate was 50.71%(357/704) including 211 strains Klebsiella pneumoniae(50.00%) and 146 strains Escherichia coli(51.77%).All strains had 100 % susceptibility to imipenem.Exept for Escherichia coli to pipracillin/tazobactam and cefoperazone/sulbactam,ESBLs-producing strains had higher resistance rate to other 9 kinds of antibiotics than non-ESBLs-producing strains.Conclusion ESBLs-producing Escherichia coli and Klebsiella pneumoniae had high resistance rate to antibiotics frequently applied in clinical and Imipenenem could be the best choice to control the infection due to serious ESBLs-producing organisms infection.