产ESBLs大肠埃希菌、肺炎克雷伯菌的分布及耐药性分析 FREE

目的了解某院大肠埃希菌、肺炎克雷伯菌产超广谱β 内酰胺酶（ESBLs）的分布及耐药特点。方法对该院2007年10月-2008年9月各科送检标本分离的大肠埃希菌和肺炎克雷伯菌，采用双纸片扩散法进行ESBLs确证试验，K B纸片扩散法进行药敏试验。结果分离出大肠埃希菌766株，其中产ESBLs株443株（57.83%）；肺炎克雷伯菌632株，产ESBLs株355株（56.17%）。产酶菌株主要分离自痰（557株，69.80%）、尿（149株，18.67%）等标本。产ESBLs菌对亚胺培南/西司他丁、美罗培南、头孢哌酮/舒巴坦敏感性高，对第一～三代头孢菌素类几乎全部耐药，对喹诺酮类、氨基糖苷类等存在交叉耐药。结论产ESBLs菌感染严重，以下呼吸道感染最多，其次为泌尿道感染；耐药率较高，亚胺培南/西司他丁、美罗培南、头孢哌酮/舒巴坦对其保持较高的抗菌活性。

Distribution and drug resistance of ESBLs producing Escherichia coli and Klebsiella pneumonia in a hospital FREE

Objective To study the distrubution and drug-resistance of Escherichia coli （E. coli） and Klebsiella pneumonia （K. pneumonia ） which produced extended-spectrum beta-lactamases （ESBLs） in a hospital. Methods The double-disk synergy test was performed to detect ESBLs-producing strains and antimicrobial susceptibility was determined by disk diffusion test in specimens collected from patients from October, 2007 to September, 2008. Results 443 of 766（57. 83%） E. coli strains produced ESBLs; 355 of 632 （56. 17%） K. pneumonia strains produced ESBLs. Most ESBLs-producing strains were isolated from sputum （557 strains, 69. 80%） and urine （149 strains, 18. 67%）. ESBLs-producing strains were susceptible to imipenem/cilastatin, meropenem and cefoperazone/ sulbactam, but resistant to almost all the first to third generation cephalosporins, and had cross resistance among quinolones and aminoglycosides. Conclusion Infections caused by ESBLs-producing strains are serious, majority are lower respiratory tract infection, the next is urinary tract infection; drug-resistance is high, imipenem/cilastatin, meropenem and cefoperazone/sulbactam have high antimicrobial activity on ESBLs-producing strains.