产超广谱β内酰胺酶细菌监测及药敏分析.docVIP

产超广谱β-内酰胺酶细菌的监测及药敏分析 　　[摘要] 目的:探讨产超广谱β-内酰胺酶(ESBLs)菌株的监测与耐药性的临床意义。方法:对临床分离出的G-杆菌,主要是肠杆菌科的细菌在进行药敏试验同时进行ESBLs的检测,采用1999年NCCLS建议的确证试验。药敏试验采用纸片扩散(K-B)法敏感试验(改良K-B法)。结果:486株共检出132株产ESBLs菌,总检出率为27.2%,其中,160株大肠埃希菌检出产ESBLs菌42株,检出率为27.0%;76株肺炎克雷伯菌检出产ESBLs菌28株,检出率为36.8%。2种主要检出产ESBLs菌株的药敏试验结果,大肠埃希菌对9种常用抗生素的敏感率依次为:亚胺培南阿米卡星阿莫西林/克拉维酸头孢哌酮/舒巴坦头孢酊庆大霉素环丙沙星妥布霉素复方磺胺甲■唑。肺炎克雷伯菌对9种常用抗生素的敏感率依次为:亚胺培南头孢哌酮/舒巴坦头孢酊阿莫西林/克拉维酸环丙沙星阿米卡星复方磺胺甲■唑妥布霉素。结论:通过对ESBLs菌株的监测掌握了解地区性细菌耐药趋势,动态观察细菌的变迁规律,将为临床合理选择抗生素、避免细菌耐药和减缓细菌耐药的发生具有重要的临床意义。 　　[关键词] β-内酰胺酶;大肠埃希菌;肺炎克雷伯菌;耐药性分析 　　[中图分类号] R978.11[文献标识码] B[文章编号] 1673-7210(2010)04(c)-107-02 　　 　　Examination and resistance analysis of producing extended-spectrum β-lactamase strains 　　MEI Chaoming 　　(Department of Clinical Laboratory, Yunfu People′s Hospital, Yunfu 527300, China) 　　[Abstract] Objective: To investigate clinical significance of examination and resistance analysis of producing extended-spectrum β-lactamase strains. Methods: The gram negative bacilli were isolated from clinic samples, mainly enterobacteriaceae bacteria, a drug sensitive test was performed by paper diffusion method(modified K-B method) and detection of esbls was done at the same time by the confirmatory test which recommended by NCCLS in 1999 for each of the strains. Results: 132 strains of esbls-producing bacteria were detected from 486 strains, the total detected rate was 27.2%, including 42 strains of esbls-producing bacteria which were detected from 160 strains of Colon Bacillus, the detection rate was 27.0%, and 28 strains of esbls-producing bacteria which were detected from 76 strains of Klebsiella Pneumoniae, the detection rate was 36.8%. The drug sensitive test results of the two main esbls-producing strains were: the sensitivity rates of Escherichia Coli to 9 commonly used antibiotics was: imipenemamikacinamoxicillin/clavulanic acidcefoperazone/sulbactamcephalosporin tincturegentamycinciprofloxacintobramycincompound sulfamethoxazole. The sensitivity rates of Klebsiella Pneumoni