大肠埃希氏菌在临床中耐药性的动态监测

目的：了解产超广谱β-内酰胺酶（ESBLs）、头孢菌素（AmpC）酶的大肠埃希菌（EC）对抗菌药物的耐药性,为指导临床合理使用抗菌药物提供科学依据。方法：用纸片扩散法（K-B法）对大肠埃希菌进行14种抗菌药物的敏感性试验,产超广谱β-内酰胺酶（ESBLs）的筛选按美国临床实验室标准化委员会（NCCLS）推荐的纸片确证法进行,去阻遏持续高产AmpC酶的检测采用双抑制剂扩散协同纸片法检测。结果：2008～2010年从临床标本中共分离到大肠埃希菌176株,其中产ESBLs阳性58株,有1株同时产AmpC酶。除亚胺培南外对其他13种抗生素均有不同程度耐药,头孢类药物耐药率较高。结论：临床EC的耐药情况十分严重,应对EC进行耐药性动态监测,以指导临床科学使用抗菌药物。

Surveillance on the Antimicrobial Resistance of Escherichia Coli in Harbin

Objective：To analyze the antimicrobial resistance for antibicterial drugs of Escherichia coli producing extended-spectrum beta-lactamases and AmpC enzyme,to provide the scientific basis for instructing clinical work of rationally using antibicterial drugs.Methods：Using K-B to do the sensibility tests of 14 antibicterial drugs for Escherichia coli and ESBLs and AmpC enzyme detection were performed with the commanding methods of NCCLS.Results：176 Escherichia coli strains were isolated from clinical samples between 2008 and 2010.ESBLs positive is 58,and one of them is AmpC enzyme positive.Antimicrobial resistance for 13 antibicterial drugs except imipenem,the higher antimicrobial resistance rate of cephalosporin.Conclusions：The antimicrobial resistance of EC is so serious in our hospital.We should dynamic surveillance the antimicrobial resistance of EC,to instruct the clinical work.