老年病人产超广谱β-内酰胺酶革兰阴性杆菌感染的临床分析

目的　了解老年病人革兰阴性杆菌产超广谱 β 内酰胺酶菌的感染情况 ,指导临床合理使用抗生素。 方法　对本院1997年 1月— 2 0 0 0年 12月 5 4 1份老年患者的痰、尿、分泌物、血及各类导管标本中分离出的革兰阴性菌进行分析 ,采用双纸片协同试验检测产超广谱 β 内酰胺酶菌株 ,纸片扩散法测定产超广谱 β 内酰胺酶菌株对 17种抗生素的敏感性。 结果　老年病人革兰阴性杆菌产超广谱 β 内酰胺酶菌株的总检出率为 19 6 % ,分泌物和尿的检出率分别为 4 2 9%和30 8%。产超广谱 β 内酰胺酶菌株伊米配能和头孢哌酮 /舒巴坦的敏感性均达 10 0 %。 结论　对老年病人产超广谱 β 内酰胺酶菌株的感染临床宜选用伊米配能和头孢哌酮 /舒巴坦治疗

Clinical Investigate of Infection of Producing Extended-spectrum β-lactamase Gram-negative Bacteriaceae in Senile Patients

Objective to study the infection condition of producing extended spectrum β lactamase gram negative bacilli in senile patients in order to direct clinical selecting effective antimicrobial agents. Methods The double disk synergy test was performed to detect ESBLs producing strains and 17 antibiotic were determined by the antimicrobial disk diffusion susceptibility tests in specimen of sputum, urine, secretion and blood with 541 senile patients. Results The total occurrence rate of producing extended spectrum β lactamase gramnegative bacilli in senile patients was 19.6%. The occurrence rate of secretion was 42.9% and urine was 30.8%. All strains of ESBLs were susceptible to imipenem and cefoperazone/sulbactam (100%). Conclusion It is better that imipenem and cefoperazone/sulbactam were used to the infection of producing extended spectrum β lactamase gram negative bacilli in senile patients.