产超广谱β-内酰胺酶细菌发生率追踪及耐药率

目的追踪调查近3年来产超广谱β-内酰胺酶(ESBLs)细菌发生率及对抗菌药物耐药率的变迁. 方法对本院2001～2003年间分离出的大肠埃希菌和肺炎克雷伯菌进行ESBLs检测,比较每年发生率并对其做4种药物敏感试验. 结果产ESBLs大肠埃希菌每年发生率分别为24.2%、29.9%和33.3%,产ESBLs肺炎克雷伯菌每年发生率分别为18.0%、26.2%、36.9%;两种细菌对氧氟沙星、阿米卡星、亚胺培南、哌拉西林/他唑巴坦的耐药率呈逐年升高,以前两者为著. 结论产ESBLs菌的发生率逐年上升,这与临床大量使用三代头孢类抗生素及不合理使用抗菌药物有关;同时ESBLs细菌对一些抗菌药物耐药率也不断增高,应引起临床治疗方面的足够重视.

Incidence and Drug Resistance Rate of ESBLs-producing Bacteria:Follow-up Studies and Analysis

OBJECTIVE To pursue the incidence and the vicissitudes of drug resistance rate of ESBLs producing bacteria in recently three years. METHODS ESBLs producing Escherichia coli and Klebsiella pneumoniae from 2001 to 2003 were detected in order to compare the per annum incidence and the result of drug sensitive test about four antibiotics. RESULTS The per annum incidence of ESBLs producing E. coli from 2001 to 2003 was 24.2%, 29.9% and 33.3%, respectively. The per annum incidence of K. pneumoniae from 2001 to 2003 was 18.0%, 26.2% and 36.9%, respectively. The drug resistance rate of the two bacteria to ofloxacin, amikacin, imipenem and piperacillin/tazobactam was increasing yearly, especially for the former two antibiotics. CONCLUSIONS The increase in the incidence of ESBLs producing bacteria is in relation to the mass clinic use of the third generation cephalosporin and the irrational use of antibiotics. Simultaneously, we must pay more attention to the clinical therapy of the ESBLs producing bacteria that have unceasingly increased in drug resistance rate.