摘要
目的探讨产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌的临床分布及耐药性特征,为临床合理选用抗菌药物及预防与控制医院感染提供依据。方法严格按照《全国临床检验操作规程》进行产ESBLs大肠埃希菌和肺炎克雷伯菌分离、鉴定;采用K-B法进行药敏试验,依据CLSI最新折点判读结果。结果从132株阳性标本中检出产ESBLs菌33株,总检出率25.00%,其中产ESBLs大肠埃希菌27株、肺炎克雷伯菌6株,检出率分别为39.71%和9.38%,未检出泛耐药产ESBLs大肠埃希菌和肺炎克雷伯菌;检出率居首位的为痰液标本,占24.24%;产ESBLs大肠埃希菌和肺炎克雷伯菌对临床常用抗菌药物均产生了严重耐药性,对亚胺培南和美罗培南高度敏感。结论肿瘤患者大肠埃希菌和肺炎克雷伯菌产ESBLs的检出率有明显增高趋势,应动态监测耐药性变迁,临床治疗中严格掌握抗菌药物应用指征,落实相关医院感染预防与控制措施,防止产ESBLs菌医院感染的暴发流行。
OBJECTIVE To study the distribution and drug resistance characteristics of extended-spectrum β-lactamases（ ESBLs） -producing Klebsiella pneumoniae and Escherichia coli in patients with tumor so as to providebasis for the reasonable clinical use of antibiotics and for the prevention and control of nosocomial infections.METHODS According to National Guide to Clinical Laboratory Operation Procedures, the ESBLs-producingK. pneumoniae and E. coli strains were isolated and identified. The antibiotic susceptibility testing was performedby K-B method and the results were assessed according to latest breakpoints of CLSI. RESULTS Among 132strains of K. pneumoniae and E. coli, totally 33 strains of ESBLs-producing isolates were isolated with the totaldetection rate of 25. 00%,including 27 （39. 71%） strains of ESBLs-producing E. coli and 6 （9. 38%） strains ofESBLs-producing K. pneumoniae^ no strains of pandrug-resistant ESBLs-producing E. coli and K. pneumoniaewere detected. The sputum ranked the first place among the specimens sources,accounting for 24. 24%. TheESBLs-producing E. coli and K. pneumoniae strains have produced severe resistance to commonly used antibiotics,but were highly sensitive to imipenem and meropenem. CONCLUSION The positive rates of ESBLs-producingK. pneumonia and E. coli in the tumor patients keep a significant upward tendency. It is necessary to dynamicallymonitor the change of drug resistance,to grasp the indications for the use of antibiotics,and to implement the related prevention and control measures so as to prevent the outbreak and prevalence of the nosocomial infectionscaused by the ESBLs-producing strains.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第17期4276-4278,共3页
Chinese Journal of Nosocomiology
基金
南通市科技计划项目(HS2012062)
关键词
大肠埃希菌
肺炎克雷伯菌
产超广谱Β-内酰胺酶
耐药性
Escherichia coli ； Klebsiella pneumoniae
Extended spectrum beta-lactamase
Drug resistance
