摘要
目的研究某医院产超广谱β-内酰胺酶（ESBLs）和质粒AmpC酶的大肠埃希菌、肺炎克雷伯菌耐药情况。方法对2006年11月-2007年7月分离的139株大肠埃希菌和102株肺炎克雷伯菌分别采用标准纸片扩散法检测ESBLS，头孢西丁三维试验检测质粒AmpC酶；并用K—B纸片扩散法进行药敏试验，根据美国临床实验室标准化委员会2002年判断标准分析结果。结果139株大肠埃希菌产ESBLs、AmpC酶及ESBLs＋AmpC酶菌株的检出率分别为48．20％、9．35％、2．88％；102株肺炎克雷伯菌产ESBLs、AmpC酶及ESBLs＋AmpC酶菌株的检出率分别为55．88％、8．82％、2．94％。产ESBLs菌株对头孢菌素类、氨基糖苷类、单环酰胺类抗菌药物耐药率明显高于非产ESBLs菌株（P〈0．001～0．05）。除碳青霉烯类及头孢他啶等抗生素外，产AmpC酶菌株对二、三代头孢菌素及喹诺酮类等药的耐药率均明显增高（P〈0．001～0．05）。结论耐药酶的产生是导致细菌耐药的重要原因之一，合理使用抗菌药物对预防耐药菌的产生和控制医院感染非常重要。
Objective To study the drug resistance of extended-spectrum beta-lactamases producing and plasmid mediated AmpC beta-lactamases-producing Escherichia coli （E. cold and Klebsiella pneurnoniae （K. pneumoniae） in a hospital. Methods One hundred and thirty nine strains of E. coli and 102 strains of K. pneumoniae were collected from clinical specimens form November, 2006 to July,2007. ESBLs production was detected by the standard disk diffusion method, and AmpC production was detected by cefoxitin three-dimensional test of enzyme-extraction. Drug susceptibility was detected by Kirby-Bauer disk diffusion method, the result were analysed by American NC- CLS Standard. Results Among 139 strains of E. coll, ESBLs-producing, AmpC beta-laetamase-prodncing, both ESBLs and AmpC betalactamase producing E. coli was 48. 20%, 9. 35% and 2. 88% respectively; among 102 strains of K. pneumoniae, the isolation rate was 55.88%, 8. 82% and 2.94% respectively. The resistant rate of ESBLs-producing strains to caphalosporins, aminoglyeosides and monobactams was obviously higher than those of non-ESBLs-producing strains （P〈0. 001 -0. 05）, except carbapenem and ceftazime, plasmid mediated AmpC betalactamase-producing strains revealed a high drug resistance to the second and third generation eephalosporins and quinolones （P〈0. 001 -0. 05）. Conclusion Production of ESBLs and AmpC in bacteria are important factors in drug resistance. More attention should be paid to the use of antimicrobial agents and control of nosocomial infection.
出处
《中国感染控制杂志》
CAS
2009年第1期44-47,共4页
Chinese Journal of Infection Control
