肠杆菌科细菌超广谱β-内酰胺酶的检测及药敏分析

目的 :了解超广谱 β 内酰胺酶 (ESBLS)在肠杆菌科细菌中的产生情况及其对部分药物的敏感性 ,以指导临床合理用药。方法 :用双纸片确证试验检测肠杆菌科细菌产ESBLS 的情况 ,用纸片扩散法对 8种抗生素的体外药敏试验结果进行初步分析。结果 :产ESBLS 的肠杆菌科细菌 4 7株 ,其中大肠埃希菌 2 5株、肺炎克雷伯菌 14株、阴沟肠杆菌 5株、催产克雷伯菌 1株、鼻硬结克雷伯菌 1株、液化沙雷菌 1株。在 8种抗生素的体外药敏试验中 ,亚胺培南和美洛培南的敏感率最高 (10 0 % ) ,其次为哌拉西林 /他唑巴坦 (89.4 % )、头孢西丁 (72 .4 % )和头孢替坦 (6 5 .9% )。结论 :产ESBLS 的肠杆菌科细菌主要以大肠埃希菌和肺炎克雷伯菌为主。对于由产ESBLS 株引起的感染 ,亚胺培南和美洛培南可作为首选治疗用药。哌拉西林 /他唑巴坦优于头霉菌素类药物和其他 β -内酰胺酶抑制剂的复合制剂

Extended-spectrum β-lactamase detection in Enterobacteriaceae and antibiotic susceptibility analysis

Objective To detect the extended spectrum β lactamases(ESBL S) in family Enterobacteriaceae and analyze the antibiotic susceptibility of those ESBL S producing strains. Methods ESBL S were determined by the double disk confirmatory test and 8 antibiotic susceptibilities were tested with the disk disffusion method in those strains producing ESBL S. Results Forty seven ESBL S producing strains comprised of 25 of E.coli, 14 of K.pneumoniae, 5 of E.cloacae, 1 of K.oxytoca, 1 of K.rhinoscleromatis, and 1 of S.liquefaciens. The susceptibility rates of those strains were:100% for imipenem and meropenem, 89.4% for piperacillin/tazobactam, 72.4% for cefoxitin and 65.9% for cefotetan. Conclusion E.coli and K.pneumoniae are the prime strains producing ESBL S in Enterobacteriaceae. Imipenem and meropenem are the best drugs to deal with those ESBL S producing strains. Piperacillin/tazobactam is better than cephamycins and other β lactama/β lactamase inhibitor combination.