产超广谱β-内酰胺酶大肠埃希菌和肺炎克雷伯菌耐药性分析

目的了解并分析产超广谱β-内酰胺酶（ESBLs）大肠埃希菌和肺炎克雷伯菌的检出率及其耐药性，为临床合理用药提供依据。方法纸片琼脂扩散法做药敏试验，双纸片协同扩散法检测ESBLs，结果依据美国临床实验室标准化委员会相关文件进行判断。结果116株大肠埃希菌检出产ESBLs菌43株，检出率为37．1％；82株肺炎克雷伯菌检出ESBLs菌30株，检出率为36．6％。产ESBLs菌对多种抗生素的耐药率明显高于非产ESBLs菌，差异有统计学意义（P〈0．005），对亚胺培南全部敏感。结论大肠埃希菌和肺炎克雷伯菌产ESBLs严重，产酶菌株耐药率很高。合理使用抗感染药物是防止ESBLs产生的重要措施。

Analysis on drug resistance and ESBLs production status of Eshcrichia coli and Klebsiella pneumoniae

Objective To elucidate the detection rates and drug resistance of extended spectrum β-lactamases （ESBLs）-producing Escherichia coli （ECO） and Klebsiella pneumonia （KPN）, and to provide evidence for rational use of antibacterial agents. Methods Kirby-Bauer agar diffusion method was used to judge drug sensitivity; and double disk synergy test was used to detect ESBLs. The results were evaluated according to the relevant documents of National Committee for Clinical Laboratory Standards （NCCLS）. Results A total of 43 strains were ESBLs positive out of 116 strains of ECO,and the positive rate was 37. 1%; a total of 30 strains were ESBLs positive out of 82 strains of KNP,and the positive rate was 36.6 %. The drug resistance rate of ESBLs-producing strains to polyantibiotic was higher than that of non-ESBLs-producing strains （P〈0. 005）. All isolated strains were 100% sensitive to imipenem. Conclusion The state of ESBLs production of ECO and KPN is serious,and ESBLs producing strains are quite resistant to antibiotics. Rational use of antibacterial agents may be an effective measure to prevent ESBLs production.