摘要
目的:了解社区感染肺炎克雷伯菌超广谱β-内酰胺酶(ESBLs)及头孢菌素β-内酰胺(AmpC)酶产生的情况及耐药特性。方法:采用VITEK-60型全自动细菌鉴定仪鉴定细菌;按CLSI推荐的确证试验检测ESBL_s和K-B纸片法测定药敏结果;采用头孢西丁纸片扩散法筛选疑产AmpC酶菌株,再经三维试验确证产AmpC酶菌株。结果:从社区感染各类标本中分离的86株肺炎克雷伯菌ESBLs检出率31.4%,产AmpC酶菌株检出率19.8%,其中同产ESBL_s和AmpC酶菌株检出率8.1%;药敏试验结果:产酶株的耐药性明显高于非产酶株,同产ESBL_s和AmpC酶菌株耐药现象更为严重。结论:社区感染肺炎克雷伯菌产ESBL_s、AmpC酶菌株检出率较高,其耐药性颇为严峻。可能与社区感染患者不合理使用抗菌药有关。有必要加强社区抗菌药使用的管理,加强对社区感染细菌的检测,以减少肺炎克雷伯菌耐药菌株的产生。
Objective： To understand the detection of ESBLs and AmpC 13-Lactamase in Klebsiella pneumoniea in- fected in communities and its characteristics of resistance. Methods ： VITEK-60 automatic bacterial identification system was used to identify the bacteria, the ESBLs were detected by the confirmatory test recommended by CLSI and the drug sus- ceptibility results were tested with the method of K-B test paper. The method of cefoxitin disk diffusion was adopted to screen the suspected AmpC 13-Lactamase-producing strains and to be confirmed by the three-dimensional test of AmpC I^- Lactamase-producing strains. Results：86 strains of Klebsiella pneumoniea were separated from the types of the community infection, with the rate of detection of ESBLs being 31.4%, AmpC 15-Lactamase-producing, 19.8%, and ESBLs and AmpC, 8.1%. The results of the drug sensitive test were as follows ： the resistance of 13-Lactamase producing strains was significantly higher than that of non-13-Lactamase producing strains with the phenomenon of resistance in ESBLs and AmpC 13-Lactamase strains more serious. Conclusion：The detection rate of Klebsiella pneumoniea strains ESBLs and AmpC β- Lactamase strain infected in communities was higher and their resistance was severe. Possibly it is because the infected pa- tients in communities blindly used antibiotics. Thus it is necessary to strengthen the management of the use of antibacterial drugs and the detection of the infection of bacteria in communities in order to reduce the production of Klebsiella pneumoniea resistant strains.
出处
《药物流行病学杂志》
CAS
2012年第1期10-12,共3页
Chinese Journal of Pharmacoepidemiology
关键词
社区感染
肺炎克雷伯菌
耐药性
Community infection
Klebsiella pneumoniea
Resistance
