摘要
目的分析产ESBLs的下呼吸道感染的常见肠杆菌科细菌的耐药性及耐药特点，以及患者感染产ESBLs菌的危险因素，为临床用药提供参考。方法对我院2007年2月～2008年8月分离的下呼吸道感染的肠杆菌科细菌用梅里埃ATB152微生物分析仪进行鉴定，检测ESBLs表型和药物敏感试验。结果在检测的肠杆菌科细菌中，ESBLs总阳性率为41．3％，大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌的产酶率分别为42．0％、52．0％和35．1％，产ESBLs的菌株对除碳青酶烯类之外的抗菌药物耐药率明显高于非产酶株，其中多数差异有统计学意义（P〈0．05）。结论感染产ESBLs菌的危险因素为长期使用三代头孢菌素、使用免疫抑制剂、ICU患者、做过导尿插管、动过大手术、患慢性消耗性疾病的患者。治疗产ESBLs菌引起的感染，应选用亚胺培南、或β-内酰胺酶抑制剂的复合物，慎用三代头孢。
Objective Analysis of the production of ESBLs lower respiratory tract infections common Enterobaeteriaceae bacteria resistance and resistance characteristics, as well as ESBLs producing bacteria infection in patients with risk factors for clinical use for reference. Methods In February 2007 to August 2008 the bacteria of the Enterobaeteriaceae separation from the lower respiratory tract infection with BIOMERIEUX ATBI525 microbial analyzer to identify, detect ESBLs phenotype and drug sensitivity tests. Results In the detection of Enterobaeteriaeeae bacteria, ESBLs positive rate was 41.3%, Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae of the enzyme production rates were 42.0% ,52.0% and 35.1%. All ESBLs producing strains were susceptible to earbapenems. The resistance rate of to most antibiotieswas much higher than those of non-ESBLs producing strains. Conclusion ESBLs producing bacteria infection risk factors for long-term use of third-generation cephalosporins, the use of immunosuppressive agents, ICU patients, catheterization done intubation, the move had major surgery, chronic wasting disease patients. ESBLs production treatment of infections caused by bacteria, imipenem should be chosen, or β-laetamase inhibitor of the complex, third-generation cephalosporin drugs used with caution.
出处
《临床肺科杂志》
2009年第5期614-615,共2页
Journal of Clinical Pulmonary Medicine
