产超广谱β-内酰胺酶细菌的临床分布及耐药特征

目的 了解本地区产超广谱β-内酰胺酶(ESBLs)细菌的临床分布及耐药特性。方法 采用双纸片扩散法对临床分离的革兰阴性杆菌(G^-B)进行ESBLs确证试验，并将ESBLs产生株的临床分布及其对常用抗菌药物的耐药性进行分析。结果 在613株G^-B中，共检出产ESBLs上细菌108株，检出率为17．6％。ESBLs产生株主要见于大肠埃希菌(45／155，29．0％)和肺炎克雷伯菌(39／133，29．3％)；标本来源主要为痰液标本，其次为尿液标本和创面分泌物；科室分布以重症监护病房(ICU)和呼吸科最多，其次为肾内科和神经内科：ESBLs产生株对大多数常用抗菌药物呈现高度耐药，敏感性较高的只有亚胺培南、哌拉西林／三唑巴坦等抗菌药物。结论 产ESBLs细菌临床分布广泛，对大多数抗菌药物呈现多重耐药，需引起临床的高度重视。

Antibiotic resistant patterns and clinical distribution of isolates of bacilli with extended spectrum beta-lactamase

Objective To analysis the antibiotic resistant patterns and clinical distributions of isolates of Gram-negative bacilli which produce extended beta-lactamase(EBSLs). Methods The antibiotic resistant patterns and identification of Gram-negative bacilli isolated from clinical infections were performed by M/A-40 bactera analysis system. Double plate diffusion method was used for the confirmatory assays of ESBLs.Results Out of 612 isolates of Gram-negative bacilli with ESBLs, 108 were capable of yielding ESBLs(17.6%). The isolates with EBSLs were E.coli(45/155,29.0%), K.pnenumoniae(39/133,29.3%).The strains with ESBLs were mainly isolated from such samples as sputum,urine, and secretions of surgical wounds.The infections of Gram-negative bacilli with ESBLs were also involved with intensive care unites,respiratory words and nephrological wards.These strains with ESBLs are highly resistant to most common available antibiotics,but sensitive only to imipenem(IMP),P/T.Conclusion The isolates of Gram-negative bacilli with ESBLs were commom,and highly cross resistant to a wide range of antibiotic drugs.Therefore,it is very important to identify these strains with ESBLs for the clinical treatments.