大肠埃希氏菌和肺炎克雷伯氏菌对第三代头孢菌素的耐药情况

目的：检测大肠埃希氏菌和肺炎克雷伯氏菌对第三代头孢菌素的耐药性，并了解产广谱β内酰胺酶（ＥＳＢＬ）的情况。方法：采用微量肉汤稀释法测定了７种β内酰胺类抗生素对４９株大肠埃希氏菌和３５株肺炎克雷伯氏菌的抑菌浓度。结果：亚胺培南（ＩＰＭ）有极好的抗菌效应，它对两种细菌的ＭＩＣ≤４μｇ／ｍｌ。大肠埃希氏菌和肺炎克雷伯氏菌对头孢哌酮的耐药率分别达到６１．２％和２０．０％，而对含β内酰胺抑制剂的舒普深两者的耐药率分别为６．１％和８．６％。其他第三代头孢菌素耐药率在１０％～３５％。大肠埃希氏菌和肺炎克雷伯氏菌是产生超广谱ＥＳＢＬ的典型菌，以头孢他定作底物识别ＥＳＢＬ，阳性率为１１．９％。结论：对第三代头孢菌素的选择要格外慎重，对产ＥＳＢＬ的细菌亦要引起重视。

Detection of the E Coli and K Pneumoniae Strains Resistance to the Third Generation Cephalosporins

Objective: To examine the E coli and K pnenmoniae strains' resistance to the third generation cephalosporins and to understand the production of extendedspectrum lactamaes. Methods: The MIC of seven antibiotics to 49 E Coli and 35 K pneumoniae were detected by MH broth dilution. Results: The MIC of IPM is as low as 4 g/ml,with excellent antibacteria effects.The resistance percentage of CPZ to E Coli was 61.2% while that to K pneumoniae was 20%,but the resistance percentage of SPZ was lowered to 6.1% and 8.6% respectively.The other cephalosporins' resistance rate varied from 10% to 35%,the typical bacteria which produces ESBL was E Coli and the positive rate was 11.9% when ESBL was used as reactive substance to detect ESBL.HZ]Conclusion: Much attention should be paid to the choosing of the third generation cephalosporins.