摘要
目的 提高医务人员对超广谱β-内酰胺酶 (ESBL s)细菌感染的认识 ,指导临床合理使用抗菌用药。方法调查 2 0 0 2年 3月我院内科病区相继发生的伴有 ESBL s细菌感染的死亡病例 ,分析我院 2 0 0 1年 3月～ 2 0 0 2年 8月产 ESBL s菌的细菌谱及耐药情况。结果 3例死亡病例检出的产 ESBL s菌均为肺炎克雷伯菌 ,药物敏感试验显示对亚胺培南敏感 ,对其他抗生素耐药 ;2 0 0 1年 3月～ 2 0 0 2年 8月所检出的产 ESBL s菌共有 4 0株 ,其中肺炎克雷伯菌 2 0株占 5 0 % ,大肠埃希菌 9株占 2 2 .5 % ,阴沟肠杆菌、产气肠杆菌各 4株分别占 10 % ;药敏试验显示产ESBL s菌对头孢唑林、氨苄西林、哌拉西林的耐药率高达 90 %～ 10 0 %。结论 产 ESBL s菌对β-内酰胺类抗生素耐药非常严重 ,易侵袭老年患者 ,应早期使用敏感药物治疗 ,对该种菌株引起的医院感染要防治并重 ;加强病区消毒隔离措施 ,防止医院感染暴发流行。
OBJECTIVE To investigate the death cases infected by positive ESBLs bacteria and their drug-(resistance) for improving the knowledge of ESBLs bacteria and proper clinical utilization of antibiotics. (METHODS ) The clinical data of three death cases with hospital aquired infection by positive ESBLs bacteria in Aug 2002, and the drug sensitivity results of positive ESBLs bacteria from Mar 2001 to Aug 2002 were studied retrospectively. RESULTS The strains isolated from sputums in the three death cases were susceptible to imipenem and unsusceptible to other antibiotics. A total of 40 ESBLs. producing strains were isolated from Mar 2001 to Aug 2002. There were 20 strains of K. pneumoniae (50%), 9 strains of Escherichia coli (22.5%), 4 strains of Enterobacter cloacae (10%) and the same of E. aerogenes. The drug sensitivity tests showed that these strains were multiresistant to commonly used antibiotics, such as cephalosporins (cefazolin, ceftazidime), ampicillin, aztreonam and piperacillin. The resistance rate of ESBLs-producing strains to cefazolin, ampicillin and piperacillin was 90-100%. All tested strains, however, were susceptible to imipenem. CONCLUSIONS There is very high resistance rate of ESBLs-producing strains to commonly used antibiotics. It′s very important for clinicians to select sensitive antibiotics to deal with the cases infected by ESBLs-producing strains. Early appraisement of microorganism, correct and appropriate treatment according to drug sensitivity can help it. It′s also necessary to isolate the patients with positive-ESBLs bacteria to prevent and control the prevalence of ESBLs-producing bacteria.
出处
《中华医院感染学杂志》
CAS
CSCD
2004年第7期830-832,共3页
Chinese Journal of Nosocomiology
关键词
超广谱Β-内酰胺酶
医院感染
耐药性
Extended-spectrum beta-lactamases
Nosocomial infection
Drug resistance
