摘要
目的分析医院感染大肠埃希菌产ESBLs、AmpC酶的情况及耐药性状况。方法双纸片协同试验及纸片扩散确证试验检测超广谱β-内酰胺酶(ESBLs),三维试验方法检测头孢菌素酶(AmpC酶);对医院及社区感染大肠埃希菌的ESBLs检出率、产与非产ESBLs医院感染大肠埃希菌在病原学结果出现前两周的抗菌药物应用情况及对17种抗菌药物的耐药率进行比较。结果医院感染大肠埃希菌的ESBLs检出率55.1%,AmpC酶的检出率为17.4%;病原学结果出现前两周使用头孢菌素及碳青酶烯类抗菌药物对医院感染大肠埃希菌产与非产ESBLs间差异有统计学意义;医院感染大肠埃希菌对碳青酶烯类药物以外的15种抗菌药物出现不同程度的耐药,比较敏感的抗菌药物尚有哌拉西林/他唑巴坦、头孢哌酮/舒巴坦及阿米卡星。结论医院感染大肠埃希菌ESBLs携带率高,可同时携带AmpC酶及其他耐药基因,造成多药耐药;需加强对抗菌药物应用的规范化管理,提高临床医师合理使用抗菌药物的意识。
OBJECTIVE To analyze the situation of extended spectrum β-1aetamases （ESBLs） and AmpC enzyme produced by nosocomial Escherichia coli isolates in 2005-2007. METHODS ESBLs were detected by double disk synergy test and disk diffusion confirmatory test. AmpC enzyme was detected by the three dimensional assay. Chi square test was used to test the significance. The application of different kinds of antimicrobials before the results of etiology be presented and the resistence rate of the ESBLs both producing and no producing were compared respectively. RESULTS The detectable rate of ESBLs in E. coli isolates of nosocomial and community infection was 55.1% and 21.3% and the detectable rate of AmpC enzyme nosocomial E. coli isolates was 17.4%. All strains were 100% susceptible to meropenem and imipenem but resistant to 15 other antimicrobials in different degree. The sensitivity to Piperacillin/tazobactam, cefoperazone/sulbactam and amikacin were relatively high. CONCLUSIONS The carrying rate of ESBLs from nosocomial E. coli isolates is high and AmpC enzyme and other resistance genes, which lead to muItiple drug resistance. Standardized management of antimicrobials application should be strengthened and the consciousness of rational antimicrobials utilization should be raised.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2009年第17期2337-2340,共4页
Chinese Journal of Nosocomiology
