临床分离菌超广谱β-内酰胺酶的检测及耐药性分析

目的了解本地区产ESBLs菌的比例及耐药特征,为临床医师治疗选药时提供参考。方法按NCCLS推荐的ESBLs确证试验对大肠埃希菌和肺炎克雷伯菌进行ESBLs检测并用ATBExpression细菌鉴定及药敏智能系统进行耐药性的测定。结果在179株大肠埃希菌、90株肺炎克雷伯菌中ESBLs的检出率为31%、27%;产ESBLs菌对青霉素类、头孢菌素类抗生素表现为很高的耐药性,对氨基糖苷类、喹诺酮类和磺胺类药物交叉耐药,但对含酶抑制剂的复合制剂和碳青霉烯类药物敏感。结论治疗ESBLs菌引起的感染应以含酶抑制剂的复合制剂和碳青霉烯类为首选。

Detection of Extended spectrum β- lactamases Strains and Resistance Analysis

Objective: To investigate the ratios and the resistance character of producing extended spectrum β -lactamases stains in our area to supply clinical physician a better reference to treat patients. Methods: we used the assured method recommended by NCCLS to determine ESBL-producing stains from Klebsiella pneumonia and Escherichia coli and detected their resistance by ATB Expression system. Results: Among 179 strains of Escherichia coli .and 90 strains of Klebsiella pneumonia the ratios of producing ESBLs stains were 31%, 27% respectively. ESBL-producing stains showed a higher resistance rate to penicillins and cephalosporins and cross-resistant to aminoglycosides, quinolones and sulfonamides . But the strains were susceptible to the compound including inhibitor and carbapenems. Conclusions: The optical drugs to treat the infections caused by ESBLs producing strains are the compound including inhibitor and carbapenems.