摘要
目的了解医院2009—2011年分离的产超广谱β-内酰胺酶（ESBLs）大肠埃希菌临床分布及耐药性变化，以指导临床用药。方法常规培养分离细菌，采用美国DADE BEHRING Micro Scan分析系统鉴定菌种，K—B纸片法进行药敏试验。结果446株产ESBLs大肠埃希菌占同期分离大肠埃希菌的48．4％，其中尿液190株占42．6％，痰液109株占24．4％，分泌物45株占10．1％；主要分布在儿科、肾内科和泌外科等科室；产ESBLs菌株对亚胺培南以外的其余19种抗菌药物耐药率高于非产ESBLs大肠埃希菌；446株产超广谱β-内酰胺酶对亚胺培南均敏感，对阿米卡星、头霉素类和陟内酰胺酶复合抑制剂的耐药率维持在9．0%～13．7％的较低水平。结论产ESBLs大肠埃希菌检出率较高且显示多药耐药，治疗产ESBLs大肠埃希菌的感染可经验选用酶抑制剂复合制剂及头霉素类药物，并可联合阿米卡星，重症感染可选用碳青酶烯类药物。
OBJECTIVE To understand the distribution and antibiotic resistance of 446 strains of extended-spectrum β-1actamases （ESBLs）-producing Escherichia coli isolated from 2009 to 2011 so as to guide the clinical use of antibiotics. METHODS The bacterial culture and isolation were performed with routine method, the bacterial identification was carried out with the use of American DADE BEHRING MicroScan analytical system, and the drug susceptibility testing was performed by using K B method. RESULTS Among the E. coli strains isolated during the same period, there were 446 （48.4%） strains of ESBLs-producing E. coli, among which 42.6% （190 strains） were isolated from urine, 24.4% （109 strains） from sputum, 10.1% （45 strains） from secretions; the strains were mainly distributed in the pediatrics department, nephrology department, and urology department. The drug resistance rates of the ESBLs-producing strains to all the 20 antibiotics were higher than those of the non-ESBLs-producing strains except for imipenem; all the 446 strains of ESBLs-producing E. coli were susceptible to imipenem, and the drug resistance rates to amikaein, cephalosporins, and β-1actamases inhibitor compound varied from 9.0% to 13.7%. CONCLUSION The detection rate of the ESBLs-producing E. coli is high, and the strains are multidrug-resistant; the enzyme inhibitor compound and cephalosporins can be used for the treatment of ESBLs producing E. coli infection and can also be used for combination with amikacin; carbapenems antibiotics are recommended for the patients with severe infections.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第23期5820-5822,共3页
Chinese Journal of Nosocomiology
基金
宝鸡市卫生局科研基金项目(2012-36)
关键词
大肠埃希菌
超广谱Β-内酰胺酶
耐药率
Escherichia coli
Extended-spectrum β-lactamase
Drug resistance rate
