阴沟肠杆菌感染154例耐药性分析

目的分析阴沟肠杆菌耐药机理及现状,指导临床合理应用抗生素。方法收集医院分离到的154株阴沟肠杆菌,采用湖南天地人生物科技公司提供的微生物生化药敏卡进行药敏检测;用双纸片协同扩散法检测超广谱β-内酰胺酶;通过改良酶提取物头孢西丁和头孢曲松三维试验检测AmpC。结果阴沟肠杆菌对临床常用抗生素呈高度耐药;产酶株的耐药性明显高于非产酶株,耐药现象在同时产AmpC酶和ESBLs菌株中尤为严重,96%菌株对亚胺培南敏感。结论阴沟肠杆菌感染的治疗可根据药敏选用氨基糖苷类及喹诺酮类药物,感染严重者可采用碳青霉烯类抗生素。

Infections caused by 154 strains of enterobacter cloacae: clinical distribution and analysis of the drug resistance

Objective To analyze the mechanism status of drug resistance to enterobacter cloacae. To direct the reasonable use antibiotics in clinic.Method 154 strains of enterobacter cloacae were collected from the hospital.A drug sensitive test was performed with microorganism biochemistry-drug sensitive card.And a ESBLs test was performed with Kinby-Bauer method. The phenotypes of E cloacae strains harboring AmpC ESBLs were detected by modified three-dimensional extracts.Result Enterobacter cloacae has higher resistance to the antibiotics often used in clinic. The resistance in AmpC-lactamases or ESBLs producer was obviously higher than that of non-AmpC-lactamases and ESBLs producer ,while the phenomenon of resistance was serious especially in AmpC-lactamases combined with ESBLs producer,but 96% of strains were sensitive to meropenem.Conclusion According to the result of drug sensitive test,arninoglycosides and quinolones may be selected to tread the infections caused by enterobacter cloacae. Carbopenems may be considered for use in critical patients.