摘要
目的探讨重庆地区近2 a儿童致泻性大肠埃希菌(E.coli)腹泻的病原菌分布、药敏情况及耐药与产酶间的相关性,为临床治疗提供依据。方法对重庆医科大学附属儿童医院2005年1月-2006年12月收集保存的31株E.coli分别采用表型确证法检测其产超广谱β-内酰胺酶(ESBLs)、表型筛选法检测头孢菌素(AmpC)酶及药物纸片法检测其药敏情况。其中,致病性大肠杆菌18株、产毒性大肠杆菌8株、侵袭性大肠杆菌5株,所做药敏试验的抗生素包括氯霉素、阿米卡星、庆大霉素、诺氟沙星、环丙沙星、头孢哌酮、头孢曲松、头孢他啶、头孢噻肟、头孢吡肟、亚胺培南。采用SPSS 12.0软件进行统计学分析。结果31株E.coli对亚胺培南的耐药率为3.2%,对氟喹诺酮类(诺氟沙星、环丙沙星)的耐药率分别为35.5%、38.7%,对氨基糖甙类(阿米卡星、庆大霉素)的耐药率则超过60%,对头孢菌素耐药率更高,均超过67.7%(头孢他啶、头孢吡肟除外);总产酶率为87.1%,单产ESBLs、单产AmpC酶、同时产ESBLs和AmpC酶的检出率分别为64.5%、6.5%和16.1%;单产AmpC酶与单产ESBLs及产2种酶的E.coli的耐药性比较均有显着性差异(Pa<0.05)。结论产酶与否及产酶的种类与细菌耐药有明显相关性;重庆地区儿童致泻性E.coli的产酶率较高,且产酶状况不同,耐药情况也有差异。
Objective To investigate the distribution of pathogenic bacteria, drug sensitivity, and the relationship between drug sensitivity and Escherichia cob （E. coli） induced enzymes in childhood diarrhea in the last 2 years in Chongqing area, so as to provide important evidence for pediatric clinical therapy. Methods Thirty - one E. coli induced enzymes, extended spectrum β - laetamases （ ESBLs ）, cephalosporinase （AmpC） detected in different phenotype methods, and drug sensitivity was measured in paper strip method, and the specimens were collected from children＇s hospital affiliated to chongqing university of medical sciences from Jan. 2005 to Dec. 2006 were determined. Among the total, there were 18 enteropathogeic E. coli （EPEC） strains, 8 enterotoxigenic E. coli（ ETEC ） strains and 5 enteroinvasive E. coli（ EIEC ） strains. In addition, drug resistance tests by paper strip included chloramphenicol （ CHL）, amikacin （ AMK）, gentamicin （ GEN ）, norfloxacin （ NOF）, ciproflocacin （CIP）, cefazolin （ CEZ ）, cefoperazone （ CPZ ）, ceftriaxone （ CRO ）, ceftazidime （ CAZ ）, cefotacime （CTX）, cefepime （FEP）, imipenem （IPM）. SPSS 12.0 software was used to analyze the data. Results Three point two percent of the 31 E. coli were drug resistant to IPM, and 35.5% ,38.7% to NOF, CIP individually, but more than 60% to AMK, GEN, even moire than 67.7% towards cephalosporin（ except ceflazidime and cefepime） ;the gross enzyme - produced rate was 87.1% , rate of single ESBLs, AmpC, and induction of both enzymes simultaneously presented 64.5% ,6.5% , 16.1% respectively;and there was marked difference in drug resistance when bacteria that produced single AmpC versus bacteria that produced single ESBLs or that produced both ESBLs and AmpC （Pa 〈 0.05 ）. Conclusions The relationships among enzyme＇s quantity, sort and bacterial resistance are different. These data show E. coli infected by bacterial diarrhea children in Chongqing due to a high rate of induced
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2008年第7期529-531,共3页
Journal of Applied Clinical Pediatrics
关键词
大肠埃希菌
药敏试验
超广谱Β-内酰胺酶
头孢菌素酶
儿童
Escherichia coli
examination of drugs＇ sensitivity
extended spectrum β - lactamases
cephalosporinase
child
