摘要
目的了解本院目前常见的革兰阴性杆菌菌种分布及产超广谱β-内酰胺酶(ESBLs)和头孢菌素酶(AmpC)情况,分析产酶菌耐药谱特征。方法用法国生物梅里埃公司的VITEK-2细菌鉴定与药敏系统对革兰阴性杆菌进行鉴定,对可疑产ESBLs、AmpC的菌株,用标准纸片扩散法和三维试验法进行两种酶的表型确证,再用纸片扩散法行药物敏感性检测。结果检出单产ESBLs、单产AmpC、同时产ESBLs和AmpC的细菌分别为175株(43.8%)、54株(13.5%)和28株(7.0%)。ESBLs检出率以肺炎克雷伯菌最高,为60.3%;AmpC检出率在阴沟肠杆菌中最高,为46.7%。单产ESBLs菌株对亚胺培南、头孢哌酮/舒巴坦以及哌拉西林/三唑巴坦的敏感性较高,耐药率分别为2.3%、26.3%和33.1%;单产AmpC菌株对亚胺培南和头孢吡肟具有较高的敏感性,耐药率分别为3.7%和29.6%;同时产AmpC和ESBLs的菌株仅对亚胺培南敏感,未发现耐药株。结论革兰阴性杆菌产ES-BLs、AmpC率较高,该类菌对大多数新型广谱β-内酰胺类抗生素耐药,对亚胺培南敏感。
Objective To investigate the strains distribution of common Gram-bacterial bacilli and the preva- lence of extended-spectrum β-1actamases（ESBLs） and AmpC- producing Gram-negative bacteria form our hospital, and to analyze their characteristics of drug resistance spectra. Methods Gram-negative bacteria were identified with VITEK-2 and the drug sensitivity system, suspected ESBLs-isolates were identified with the method recommended by the National Committee for Clinical Laboratory Standard（NCCLS）. AmpC- producing and AmpC-producing com- bined with ESBLs-producing strains were detected by three-dimensional test. The antimicrobial susceptibility of AmpC-producing and ESBLs-producing strains were detected by Kirby-Bauer methods. Results ESBLs,AmpC-pro- ducing and AmpC-producing combined with ESBLs-producing strains were found in 175 starins （43.8%）,54 strains （13. 5%） and 28 strains （7.0%） respectively. Among ESBLs-producing strains, the most common isolates were Klebsiella pneumoniae（60.3% ）and Escherichia coli（49.2 % ）. The most common AmpC-producing strains was Enter- obacter cloacae （46.7% ）. The AmpC-producing strains were more susceptible to imipenem and cefepime,its resistant rates were 3.7% and 29.6% respectively. The resistant rates of ESgLs-producing strains to imipenem, eefopera- zone/sulbaetam piperacillin/sulbactam and were 2.3%, 26.3 % and 29.6 % respectively. AmpC-producing combined with ESBLs-producing strains were only sensitive to imipenem, imipenem-resistant strain was not found. Conclusion ESBLs-produeing and AmpC-producing gram-negative strains are common in clinical isolates from hospi- tal,and resistant to the majority of new broad spectrum β-lactamas,but sensitive to imipenern.
出处
《检验医学与临床》
CAS
2012年第7期804-806,共3页
Laboratory Medicine and Clinic
关键词
革兰阴性杆菌
超广谱Β-内酰胺酶
头孢菌素酶
耐药性
gram-negative bacteria
extended-spectrum β-lactamases
AmpC-producing
drug resistance
