产超广谱β-内酰胺酶大肠埃希菌和肺炎克雷伯菌的检测与耐药性分析

目的:了解大肠埃希菌和肺炎克雷伯菌产ESBLs的检出率及耐药性。方法:采用2007年CLSI/NCCLS推荐的初筛试验方法,从352株大肠埃希菌和肺炎克雷伯菌中筛选出可疑产ESBLs细菌,并用验证试验加以确证,药敏试验采用Kirby-Bauer法。结果:大肠埃希菌和肺炎克雷伯菌ESBLs的检出率分别为42.68%(105/246)和52.83%(56/106);产ESBLs株对亚胺培南高度敏感,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和头孢西丁耐药率较低,对其他抗菌药物的耐药率均较不产ESBLs株高。结论:重视产ESBLs细菌的检测,根椐药敏试验合理用药,亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和头孢西丁是目前治疗ESBLs株的有效药物。

Detection and Analysis of Antimicrobial Resistance of Extendedspectrum Beta-lactamase Produced K. Pneumoniae and E. Coli

Objective:To investigate the resistance and extended-spectrumβ-lactamases (ESBLs) in E.coli and K.pneumoniae.Methods:ESBLs production was detected by CLSI/NCCLS phenotypic confirmatory test in E.coli (n=246) and K.pneumoniae (n=106).Antimicrobial susceptibility was tested by Kirby-Bauer method.Results:The positive rates of ESBLs-producing among E.coli and K.pneumoniae were 42.68% and 52.83% respectively.ESBLs producing strains in our study were highly susceptible to imipenem,and relatively susceptible to cefoperazone/sulbactam,piperacillin/tazobactam and cefoxitin.ESBLs-producers had much higher resistance rates to other antimicrobial agents compared with ESBLs non-producing strains.Conclusion:It is very important to determine ESBLs producing strains.Correctly selecting antibiotics for infection treatment is conducted according to the results of susceptibility tests.Imipenem,cefoperazone/sulbactam,piperacillin/tazobactam and cefoxitin are the effective antibiotics to infections caused by ESBLs-producing strains.