摘要
目的了解女性阴道分泌物中产超广谱β-内酰胺酶(ESBLs)肠杆菌科细菌分布现状及耐药情况,为临床治疗提供依据。方法收集复旦大学附属妇产科医院2014年1月至2017年12月女性阴道分泌物分离的肠杆菌科细菌939株,应用VITECK 2Compact全自动细菌鉴定分析仪进行菌株鉴定及药敏试验,分析产ESBLs肠杆菌科细菌的检出率和耐药性。结果 939株肠杆菌科细菌检出产ESBLs菌株257株,检出率为27%;其中共包含大肠埃希菌220株,肺炎克雷伯菌34株,臭鼻克雷伯菌2株,产酸克雷伯菌1株。产ESBLs大肠埃希菌和肺炎克雷伯菌对氨苄西林和头孢唑啉全部耐药,对头孢他啶、呋喃妥因、复方SMZ、阿米卡星、环丙沙星、庆大霉素、妥布霉素、氨苄西林/舒巴坦、头孢曲松、厄他培南、哌拉西林/他唑巴坦、氨曲南、头孢吡肟、左氧氟沙星的耐药率分别为36%和44%,2%和41%,67%和68%,2%和15%,58%和38%,51%和65%,14%和26%,65%和76%,99%和97%,0%和29%,0%和3%,50%和65%,26%和18%,57%和32%,但对亚胺培南和头孢替坦全部敏感。结论女性阴道分泌物产ESBLs肠杆菌科细菌携带率较高,亚胺培南、头孢替坦、哌拉西林/他唑巴坦有较高的抗菌活性,可作为初始治疗的经验用药。
Objective In order to understand the distribution and drug resistance of the extended-spectrumβ-lactamase-producing(ESBLs)Enterobacteriaceae in female vaginal secretions and to provide the basis for clinical treatment.Methods 939 strains of Enterobacteriaceae isolated from female vaginal secretions were collected from Obstetrics and Gynecology Hospital of Fudan University from January 2014 to December 2017.The strain identification and drug sensitivity test of VITECK 2 Compact-totally automatic bacterial identification analyzer were used to analyze the detection rate and drug resistance of ESBLs Enterobacteriaceae.Results 257 strains of ESBLs-producing strains were detected in 939 strains of Enterobacteriaceae with a detection rate of 27%,including 220 Escherichia coli,34 Klebsiella pneumoniae,2 Stink-nose Klebsiella and 1 strain of Acidogenic Klebsiella.ESBLs Escherichia coli and Klebsiella pneumoniae were all resistant to Ampicillin and Cefazolin,and to Ceftazidime,Nitrofurantoin,SMZ,Amikacin,Ciprofloxacin,Gentamicin,tobramycin,Ampicillin/Sulbactam,Ceftriaxone,Ertapenem,Piperacillin/Tazobactam,Aztreonam,Cefepime,Levofloxacin the drug resistance rates of were 36%and 44%,2%and 41%,67%and 68%,2%and 15%,58%and 38%,51%and 65%,14%and 26%,65%and 76%,99%and 97%,0%and 29%,0%and 3%,50%and 65%,26%and 18%,57%and 32%,but they are all sensitive to Imipenem and Cefotetan.Conclusion The inicdence of ESBLs Enterobacteriaceae in female vaginal secretions is high,and Imipenem,Cefotetan,Piperacillin/Tazobactam have high antibacterial activity,which can be used as the experience of initial treatment.
作者
陈雷鸣
陈艺升
石雯茜
应春妹
CHEN Leiming;CHEN Yisheni;SHI Wenqian;YING Chunmei(Department of Laboratory,Obstetrics and Gynecology Hospital of Fudan University,Shanghai,200011,China)
出处
《国际检验医学杂志》
CAS
2019年第3期348-350,共3页
International Journal of Laboratory Medicine
关键词
女性阴道分泌物
产ESBLS菌株
耐药性
female vaginal secretions
ESBLs-producing strains
drug resistance
