杭州市产超广谱β内酰胺酶大肠埃希菌和肺炎克雷伯菌耐药性研究

目的 :了解杭州市产超广谱 β内酰胺酶 (ESBLs)大肠埃希菌和肺炎克雷伯菌耐药情况。 方法 :收集杭州市区 5所医院临床分离的大肠埃希菌和肺炎克雷伯菌共 198株 ,用酶抑制剂增强纸片扩散试验确证产ESBLs细菌 ,琼脂扩散法测定其对17种抗菌药物的敏感性。结果 :12 7株大肠埃希菌和 71株肺炎克雷伯菌ESBLs检出率分别为 31.5 %和 15 .5 %。产ESBLs大肠埃希菌和肺炎克雷伯菌对亚胺培南和美罗培南耐药率为 0 ,抗菌作用较强的抗生素还有拉氧头孢、头孢哌酮 舒巴坦和哌拉西林 三唑巴坦 ,耐药率分别为 3.9%、3.9%和 2 3.5 %。而氨苄西林、复方磺胺甲唑、氨苄西林 舒巴坦、替卡西林 克拉维酸、阿莫西林 克拉维酸和环丙沙星的耐药率均 >5 0 %。结论 :产ESBLs大肠埃希菌和肺炎克雷伯菌耐药率较高 ,临床治疗中要选择适当抗菌药并对产ESBLs菌株实行监控。

Study on antibiotics resistance of extended-spectrum β-lactamases-producing Escherichia coil and Klebsiella pneumoniae in Hangzhou

Objective: To survey the antimicrobial resistance of ESBLs-producing E.coil and K.pneumoniae in Hangzhou. Methods: A total of 198 isol ates of E.coil and K.pneumoniae were collected from five hospitals in Hangzhou. ESBLs-produci ng isola tes were detected by inhibitor-potentiated disc diffusion test and the bacteria l susceptibility test against 17 antibacterial agents was done by agar dilution test. Results: The incidence of ESBLs in 127 E.coil and 71 K.pneumoniae isolates were 31.5% and 15.5%, respectively. The resistant rates of ESBLs-producin g E.coil and K.pneumoniae isolates to imipenem and meropenem were zero and resistant rates to trimethoprim-sulfamethoxazole, ampicillin-sulbactam, ticarcillin-clavulanic a cid, amoxicillin-clavulanic acid and ciprofloxacin were more than 50%. Conclusions: The resistant rates of ESBLs-producing E.coil and K.Pneumoniae isolates to most antimicro bial agents were higher than that of non-ESBLs-producing isolates. Antibiotics should be used rationally in the treatment of infections caused by ESBLs-producing strains. A surveilla nce program should be worked out.