院内和社区感染大肠埃希菌超广谱β-内酰胺酶的检测

目的：了解院内和社区感染患者标本中分离的大肠埃希菌ESBLs(超广谱β-内酰胺酶)的产生及耐药情况。方法：采用体外扩散确证试验检测。ESBLs，同时用VITEK-AMS和K—B琼脂扩散法进行体外药敏试验。结果：社区感染标本中分离出大肠埃希菌86株，产ESBLs菌株28株，阳性率为32．6％，其中尿液标本中分离出42株，产ESBLs菌株17株，阳性率为40．5％；院内感染标本中分离出大肠埃希菌95株，产ESBLs菌株50株，阳性率为52．6％，其中尿液标本中分离出53株，产ESBLs菌株22株，阳性率为41．5％。社区和医院感染大肠埃希菌ESBLs产生率存在差异有显著性，但从尿液标本中分离的大肠埃希菌其ESBLs产生率差异无显著性。ESBLs阳性株对多种抗生素耐药，其耐药性明显高于ESBLs阴性株。结论：本地区ESBLs产生情况十分严重。在抗感染治疗中，尤其是社区应加强广谱抗生素管理和使用。

DETECTION OF EXTENDED-SPECTRUM β-LACTAMASES PRODUCED BY ESCHERIA COLI DUE TO NOSOCOMIAL AND SOCIAL-ACQUIRED INFECTION

Objective:To determine the prevalence and resistance of nosocomial infection and social-acquired infection caused by ESBL-producing Escherichia coli.Methods:Double-disk synergy test was used to detect ESBLs,antibiotic susceptibility test by VITEK-AMS and Kirby-Bauer test.Results:86 strains of Escherichia coli were isolated from social-acquired infection,ESBLs strains accounted for 28(32.8%).Among these,42 strains were isolated from urin and ESBLs strains 17(40.5%);95 strains of Escherichia coli isolate from nosocomial infection,ESBLs strains accounted for 50(52.6%).Among these,53 strains were isolated from urin and ESBLs strains 22(41.5%);ESBLs strains were high resistant to more antibiotics and more resistant than ESBLs negative strains.Conclusion:ESBLs produced by Escherichia coli are very serious in our area.The percent of ESBL-producing strains show significant difference between nosocomial infection and social-acquired infection and no significant difference isolate from urin.To deal with infectious disease,broad-spectrum antibiotic should be controlled properly.