阴沟肠杆菌感染的临床分布与耐药性分析

目的 了解医院近两年阴沟肠杆菌临床分布及其耐药性.方法 药敏试验采用K-B法,AmpC酶和ESBLs检测采用三维试验.结果 共分离106株阴沟肠杆菌,烧伤科是检出最高的科室;菌株检出数最多的标本是痰、创面、胆汁和引流液;药敏结果表明,阴沟肠杆菌对青霉素类、一、二代头孢菌素及头孢西丁高度耐药,第三、四代头孢菌素的耐药率为24.5%～50.9%;共检出产ESBLs菌29株,检出率27.4%;检出产AmpC酶菌43株,检出率40.6%,其中有23株为同时产ESBLs和AmpC酶.结论 阴沟肠杆菌的临床检出率和耐药率日趋严重,应加强实验室的检测,以控制阴沟肠杆菌引起的医院感染.

Distribution and Drug Resistance of Enterobacter cloacae from Clinic

OBJECTIVE To analyze the drug-resistance of Enterobacter cloacae isolated from clinic in the past two years. METHODS The drug-resistance by K-B method, and to perform 3-D test to detect AmpC β-lactamase and ESBLs were detected. RESULTS One hundred and six strains of E. cloacae was detected. Burn department were the wards which had the highest detection rate. Sputum, wound, bile and drainage fluid had the highest positive rate. Sensitivity test results showed that the resistance rate to penicilins, Ⅰ, Ⅱ-generation cephalosporins and cefoxitin of E. cloacae was the highest, and the resistance rate to the third, and fourth-generation cephalosporins was 24.5-50.9%. The detection rate of ESBLs and AmpC was 27.4% and 40.6%, respectively. Twenty three strains produced both of them. CONCLUSIONS The detection rate and drug resistance of E. cloacae are increasing severely. Laboratory should pay more attention to their detections and surveillance so as to control hospital infection of E. cloacae.