产超广谱β―内酰胺酶大肠埃希菌120例药敏分析.docVIP

产超广谱β―内酰胺酶大肠埃希菌120例药敏分析 　　doi：10.3969/j.issn.1007-614x.2014.21.5 　　摘 要 目的：探讨婴幼儿感染产超广谱β-内酰胺酶（ESBLs）大肠埃希菌的分布特点及药敏情况，指导临床合理选用抗菌药物治疗。方法：2011年12月-2013年12月送检的痰、血液、脑脊液等标本进行一般细菌培养，血液注入小儿中和抗生素血培养瓶，放置BacT/ALERT3D血培养仪培养，用法国生物梅里埃系统鉴定细菌，以K-B法进行药敏分析。结果：共检出大肠埃希菌120株，其中有49株产ESBLs（40.83%），其中2012年检出大肠埃希菌52株，有13株产ESBLs（25.0%）；2013年检出大肠埃希菌68株，有36株产ESBLs（52.94%）。118株分离自呼吸道标本（98.33%），2株分离自血液（1.67%）。49株产ESBLs大肠埃希菌对青霉素类、头孢菌素类100%耐药，对氨苄西林/舒巴坦和替卡西林/克拉维酸的不敏感率分别为73.6%和42.3%；对哌拉西林/他唑巴坦20.6%中度敏感，79.4%敏感，对头孢哌酮/舒巴坦高度敏感，敏感率86.32%。未出现耐亚胺培南或美洛培南菌株。结论：新生儿感染大肠埃希菌以呼吸道标本检出最多，ESBLs阳性率2013年比2012年有明显升高趋势，对β-内酰胺类抗菌药物耐药严重，多重耐药现象不容乐观，临床应根据药敏试验结果合理选用抗菌药物，避免诱导型耐药菌株的产生。 　　关键词 超广谱β-内酰胺酶 婴幼儿 大肠埃希菌 感染 　　Drug sensitivity analysis of production of extended spectrum beta lactamase in escherichia coli in 120 cases 　　Li Fang，Jing Miao，Sun Chuntao 　　Clinical Laboratory，the Maternal and Child Health Hospital of the Ningxia Hui Autonomous Region（Yinchuan City，Ningxia） 750004 　　Abstract Objective：To investigate the distribution and drug resistance situation of production of extended spectrum beta lactamase（ESBLs） in escherichia coli infection in infants and young children，to guide the clinical rational use of antimicrobial drugs.Methods：Sputum，blood，cerebrospinal fluid and other specimens from December 2011 to December 2013 underwent general bacterial culture，blood was injected in antibiotics and blood culture bottle.The blood was placed in the BacT/ALERT3D blood culture for culture.Bacteria were identified by the French bioMerieux system.We conducted sensitivity analysis using K-B method.Results：There were 120 strains of escherichia coli，including 49 ESBLs producing strains（40.83%）.In 2012，there were 52 strains of escherichia coli，including 13 ESBLs producing strains（25%）.In 2013，there were 68 strains of escherichia coli，including 36 ESBLs producing strains（52.94%）.118 strains were isolated from respiratory tract（98.33%），and 2 strains were isolates from blood （1.67%）.49 ESBLs producing strains of escherichia coli