尿路感染大肠埃希菌产AmpC酶和超广谱β-内酰胺酶的检测及耐药性分析

目的:了解尿路感染患者中大肠埃希菌产AmpC酶和超广谱β-内酰胺酶(ESBLs)的情况及耐药性分析。方法:采用纸片扩散确证法检测ESBLs,酶提取物三维试验方法检测AmpC酶。结果:130株大肠埃希菌中检出单产ESBLs45株,AmpC酶8株,同时产AmpC酶和ESBLs共5株,检出率分别为34.6%、6.2%和3.8%;产酶菌株对抗生素的耐药率大部分均高于不产酶菌株。结论:大肠埃希菌对β-内酰胺类抗生素耐药的主要原因是产生AmpC酶和ESBLs,对产酶菌株临床经验用药首选碳青霉烯类抗生素。

Detection and Drug Resistance of AmpC and Extended-spectrum β-lactamase in Escherichia Coli from Urinary Infections

OBJECTIVE： To detect and analyze the drug resistance of the AmpC and the extended - spectrum β - lacta- mases （ESBLs） in Escherichia coil （E coli） from urinary infections. METHODS： ESBLs was detected by Phenotypic Confirmatory Test and AmpC was detected by improved three dimensional test. RESULTS： The isolating rates of ESBLs（45 strains）, AmpC（8 strains） and AmpC ＋ ESBLs in E.coli（5 strains） were 34.6% , 6.2% and 3.8%, respectively. The drug resistance rates of ESBLs and AmpC - producing E.coli was higher than those of the strains without producing ESBLs or AmpC. CA）NCLUSION ： Production of AmpC and ESBLs in β - lactam antibiotics was the main resistance mechanism against E. coli. Carbopenems should be regarded as the first choice in clinical empirical medication for enzyme-producing strains.