大肠埃希菌、克雷伯菌产超广谱β-内酰胺酶的检测及耐药性分析

目的研究本院3年中大肠埃希菌、克雷伯菌ESBLs的检出率及对常用抗生素的耐药情况。方法对山西医科大学第二医院2001～2003年分离的837株大肠埃希菌、216株克雷伯菌用标准纸片扩散确证法检测其ESBLs产生率；采用K-B法进行药敏检测。结果大肠埃希菌产ESBLs分离率为2001、2002、2003分别为12．27％、15．90％、30，85％；克雷伯菌产ESBLs分离率为2001、2002、2003分别为23．88％、28．81％、30．00％；产ESBLs株对头孢菌素类、氨基糖苷类、氟喹喏酮类耐药率均高于非产ESBLs菌株；未发现对亚胺培南耐药的菌株。结论近年来大肠埃希菌、克雷伯菌产ESBLs菌株逐年升高，应引起足够的重视，采取有效措施控制产ESBLs菌的感染。

Detection of Extended-spectrum Beta Lactamases and Analysis of Antibiotic Resistance in Clinical Isolated Strains of Klebsiella and Escherichia coli

OBJECTIVE To investigate the drug resistance and the productive status of extended-spectrum beta lactamases (ESBLs) in Klebsiella and Escherichia coli, which were isolated in our hospital from 2001 to 2003. METHODS A total of 216 strains of Klebsiella and 837 strains of E. coli were collected from clinical specimens. ESBLs production was performed by the standard disk diffusion method, drug susceptibility was detected by Kirby-Bauer disk diffusion method. RESULTS ESBLs productive rate of Klebsiella (E. coli) increased significantly from 23.88% (12.27%), 28.81% (15.90%) to 30.00% (30.85%) during the years from 2001, 2002 to 2003. The resistance of ESBLs production strains to most antimicrobials were much higher than those of non ESBLs producing strains. No strains were found to be resistant to imipenem. CONCLUSIONS ESBLs production of bacteria has significantly increased, so it should be paid a great attention. Imipenem could be of the first choice to treat the infection caused by ESBLs production Klebsiella and E. coli.