摘要
目的探讨新、旧两种判读标准对大肠埃希菌药敏结果的影响,规范抗生素的使用。方法收集本院2011年11月至2013年6月住院及门诊感染患者送检标本中分离出的大肠埃希氏菌122株,纸片扩散法测定菌株对头孢他啶(CAZ)、头孢噻肟(CTX)的敏感性,美国临床实验室标准化研究所(CLSI)表型确证试验确定产ESBLs菌株,根据药物敏感性结果对产超广谱β-内酰胺酶(ESBLs)菌株和非产ESBLs菌株在S19和S20新旧折点下CAZ、CTX的敏感性以及ESBLs阳性菌株分布率进行分析。结果产ESBLs菌株CTX,非产ESBLs菌株CTX,CAZ应用S20和S19判断差异均无统计学意义,而CAZ药敏结果差异有统计学意义。结论在CLSI M100-S20规则下,体外药敏实验CTX、CAZ耐药率均有所提高,但实际报告时头孢类药物由完全耐药到部分敏感,这增加了头孢他啶等治疗临床产ESBLs菌株所致感染的用药机会。
Objective To study the effect on Escherichia coli drug sensitivity results according to the old and new standards, and more standard and reasonable administration of the use of antibiotics. Methods A total of 122 strains of e. coli isolated from inpatient and outpatient infection patients in our hospital from November 2011 to June 2012 were collected. Disc diffusion method was used to determine the sensitivity of strains to ceftazidime（CAZ） and cefotaxime（CTX）, CLSI phenotypic confirmatory test was used to confirm ESBLs producing strains. According to the result of drug sensitivity, the sensitivity of ESBLs producing strains and non ESBLs producing bacteria to CAZ, CTX in S19 and S20 between the old and the new break point and ESBLs positive strain rate distribution were analyzed. Results There was no statistically significant difference in CTX of ESBLs producing strains using S20 or S19, but statistically significant difference in CAZ. In non producing ESBLs strains, CTX and CAZ using S20 or S19 judgment was no statistically significant difference. Conclusion In the CLSI under M100-S20 rules, drug sensitivity test in vitro CTX, CAZ resistance were increased, but in the actual report, ephalosporins is from com- pletely resistant to some sensitive, which increases the ceftazidime treatment clinical infection caused by producing strain ESBLs drugs.
出处
《青岛医药卫生》
2014年第3期196-198,共3页
Qingdao Medical Journal
