摘要
目的了解湖州市中心医院肠杆菌产超广谱β-内酰胺酶(ESBLs)流行病学情况与耐药性。方法采用常规方法分离,使用VITE-COMPACT2全自动微生物分析仪进行菌种鉴定,用K-B法进行药敏试验。结果共分离到产ESBLs肠杆菌2 560株,分离率为48.4%,产ESBLs大肠埃希菌、肺炎克雷伯菌、产酸克雷伯菌、变形杆菌分离率依次为68.9%、54.6%、18.3%、25.9%,其他肠杆菌未发现产ESBLs菌株。产ESBLs大肠埃希菌、肺炎克雷伯菌、产酸克雷伯菌主要来自痰液(分别为42.2%、60.8%、57.7%),而变形杆菌主要来自尿液(为40.0%)。2008—2010年大肠埃希菌、肺炎克雷伯菌对大多数抗菌药物高度耐药,但对碳青霉烯类抗菌药物、酶抑制复合剂哌拉西林/他唑巴坦、头孢哌酮/舒巴坦及阿米卡星尚敏感。变形杆菌主要对亚胺培南、美罗培南、哌拉西林/他唑巴坦、头孢西丁、头孢哌酮/舒巴坦、阿米卡星高度敏感。结论产ESBLs肠杆菌主要为大肠埃希菌,其次为肺炎克雷伯菌。大肠埃希菌、肺炎克雷伯菌对大多数抗菌药物高度耐药,但对碳青霉烯类抗菌药物、酶抑制复合剂哌拉西林/他唑巴坦、头孢哌酮/舒巴坦及阿米卡星尚敏感。随着碳青霉烯类抗菌药物的广泛使用,开始出现耐药菌株,主要为肺炎克雷伯菌,临床上治疗非常困难,应加强院内感染管理与监测,防止耐药菌株广泛播散。
Objective To investigate the epidemiological condition of the enterobacterium that produces extended - spectrum beta - lactamases （ESBLs） and its drug resistance in Central Hospital of Huzhou City. Methods Isolation of the en- terobacterium was done by using the conventional method; strain identification by using VITE - COMPACT2 automatic microor- ganism analyzer; and the drug sensitivity test by using K - B method. Results Totally 2 560 strains of the enterobateriun produ- cing ESBLs were isolated, with a isolation rate of 48.4%. And the isolation rate for ESBLs producing escherichia coli, klebsiel- la pneumoniae, klebsiella oxytocam, and proteus were 68. 9%, 54. 6%, 18.3% and 25.9% respectively. No other enter- obacteria were found to produce ESBLs. The escherichia coli, klebsiella pneumoniae, and klebsiella oxytocam mainly came from sputum （accounting for 42. 2%, 60. 8%, 57. 7% respectively）, while proteus came mainly from urine （accounting for 40. 0% ）. In 2008--2010, the escherichia coli and klebsiella pneumoniae strains showed high degree of antimicrobial resistance to majority of antibiotics, but they were sensitive to carbapenems, enzyme inhibition composite agent piperacillin/tazobactam, cefoperazone/sutbactam, and amikacin. And the proteus was mainly sensitive to imipenem, meropenem piperacillin/tazobac- tam, cefoxitin, cefoperazone/sulbactam, and amikacin. Conclusion The escherichia coli is the mojor enterobacterium produ- cing ESBLs, followed by klebsiella pneumonia. Escherichia coli and klebsiella pneumoniae are of high antimicrobial resistance to majority of antibiotics, but sensitive to carbapenems, enzyme inhibition composite agent piperacillin/tazobactam, cefoperazone/ sulbactam, and amikacin. Along with widely application of carbapenems clinically, the drug - resistant strains begin to appear. The evident one is klebsiella pneumonia for which the clinical therapy often fails. So the nosocomial infection management and monitoring should be strengthened to prevent the drug -resistant s
出处
《中国全科医学》
CAS
CSCD
北大核心
2012年第13期1526-1528,共3页
Chinese General Practice
关键词
肠杆菌科
超广谱Β-内酰胺酶
耐药性
Enterobacteriaceae
Extended spectrum β - lactamases
Resistance
