摘要
目的检测奇异变形杆菌、大肠埃希菌和克雷伯菌属的AmpC酶,并分析其耐药性,为临床合理用药提供指导。方法 AmpC酶耐药表型检测采用三维试验,细菌鉴定采用VITEK-2 Compact进行,药敏试验采用K-B法(纸片扩散法),统计学方法采用SPSS 22.0,产酶组与不产酶组耐药率比较采用χ~2检验,P<0.05为差异有统计学意义。结果奇异变形杆菌、大肠埃希菌和克雷伯菌属的AmpC酶检出率分别为1.1%、4.0%和20.6%。产AmpC酶菌株对17种抗菌药物耐药率显著高于不产AmpC酶菌株,差异有统计学意义(P<0.05),产AmpC酶菌株对碳青霉烯类抗菌药物亚胺培南、美罗培南耐药率最低,阿米卡星、头孢哌酮/舒巴坦次之。结论临床在做常规药敏试验的同时应加强AmpC酶耐药表型的检测,科学合理用药,防止耐药表型在院内的传播,减少多重耐药菌株的出现。
Objective To investigate AmpCβ-lactamase of Proteus mirabilis,Escherichia coli and Klebsiella,and to analyze its drug resistance,so as to provide basis for clinical rational use of drugs.Methods AmpCβ-lactamase was detected by three-dimensional test,Vitek-2 compact was used for bacterial identification,K-B method(disc diffusion method)was used for drug sensitive test,SPSS 22.0 was used to statistic data,andχ~2 test was used to compare the drug resistance rate between enzyme producing group and non productive enzyme group.The P value less than 0.05 was defined as statistical significance.Results The detection rates of AmpCβ-lactamase in Proteus mirabilis,Escherichia coli and Klebsiella were 1.1%,4.0%and 20.6%,respectively.The resistance rate of the AmpCβ-lactamase group to 17 kinds of antibiotics was significantly higher than that of the non producing AmpCβ-lactamase group,and the difference was statistically significant(P<0.05).The AmpCβ-lactamase group had the lowest drug resistance rate of ipenem and meropenem,followed by Amikacin,Cefoperazone/sulbactam.Conclusion In clinical routine test of drug sensitivity,we should strengthen the detection of AmpCβ-lactamase resistance phenotype,scientifically and rationally use drugs,prevent the transmission of drug-resistant phenotype in hospital,and reduce the emergence of multidrug-resistant strains.
作者
周聪
徐茂锁
刘亚隽
张慧
胡娟
沈芳
ZHOU Cong;XU Mao-suo;LIU Ya-juan;ZHANG Hui;HU Juan;SHEN Fang(Clinical Laboratory,the Fifth People's Hospital of Shanghai,Shanghai 200240,China)
出处
《中国卫生检验杂志》
CAS
2019年第8期953-955,共3页
Chinese Journal of Health Laboratory Technology
基金
复旦大学附属上海市第五人民医院科研课题(2016WYQJ04)
