产超广谱β-内酰胺酶大肠埃希菌及肺炎克雷伯菌对九种抗菌药物的耐药性分析

目的 了解肺炎克雷伯菌和大肠埃希菌产超广谱β-内酰胺酶(ESBLs)菌株的检出率及耐药性。方法 采用琼脂稀释法对2001年4月～2002年2月四川大学华西医院从临床标本中分离的非重复大肠埃希菌和肺炎克雷伯菌进行产ESBLs株的初筛，用NCCLS推荐的纸片扩散法作确证试验，并测定产ESBLs株对9种抗菌药物的MIC值。结果 大肠埃希菌及肺炎克雷伯菌产ESBLs株的检出率分别为26．4％和18．2％。产ESBLs菌株多呈多重耐药，耐药性由高至低依次为环丙沙星(93．3％)、头孢噻肟(70％)、头孢哌酮／舒巴坦(66．7%)、氨曲南(63．3％)、阿米卡星(36．7％)、头孢西丁(20％)、头孢他定(16．7%)、头孢吡肟(10％)，亚胺培南100％敏感。结论 产ESBLs细菌多呈多重耐药。亚胺培南是治疗产ESBLs细菌感染的最可靠药物。

Resistance of ESBLs-producing Echerichia coli and Klebsiella pneumoniae to 9 antimicrobial agents

Objective To survey the prevalence and the resistance of ESBLs-producing Klebsiella pneumoniae and Escherichia coli isolated in Sichuan University Huaxi Medical Center.Methods The ESBLs-producing Klebsiella pneumoniae and Escherichia coli were isolated from clinical species in West China HospitalSichuan University from April,2001 to February,2002,and were screened and confirmed by agar dilution and double disk diffusion according to NCCLS.The MICs of nine kinds of antibiotics against the ESBLs-producing clinical isolates were detected by agar dilution.Results The incidence of ESBLs-producing K. pneumoniae and E.coli are 18.2% and 26.4% respectively.Most of the ESBLs producing strains were multidrug resistance.Their resistant rates to ciprofloxacin,aztreonam,cefoperazone/sulbactam were higher than to other drugs.All ESBLs-producing strains were susceptible to imipenem.Conclusion The incidence of ESBLs-producing strain was rather high.Most of the ESBLs-producing strains were multidrug resistance,and imipenem is still the best antibiotic for treatment of the infections caused by ESBLs-producing bacteria.