临床分离的191株产ESBLs细菌体外抗菌活性-病原生物学专业论文.docxVIP

中文摘要35．03％(55／1571，其它革兰阴性杆菌的检出率为 中文摘要 35．03％(55／1571，其它革兰阴性杆菌的检出率为 23．30％(41／1 76)。除哌拉西林／他唑巴坦、头孢哌酮／舒巴 坦、亚胺培南／西司他丁外，产ESBLs的细菌对其它10 种抗生素的耐药率均显著高于非产ESBLs菌(P0．01)。 增效抑菌试验结果显示，头孢曲松／克拉维酸复合制剂抑 酶抗菌作用最强，尤以头孢曲松／克拉维酸2：1的比例 效果最佳。 结论：191株产ESBLs革兰阴性菌中，以不动杆菌 产ESBLs的情况严重，与有些地区情况不太一致，体外 试验表明头孢曲松／克拉维酸制剂能提高头孢曲松的抑 酶抗菌作用，尤以头孢曲松／克拉维酸2：l的比例抗菌 活性最高。头孢曲松／舒巴坦联合应用效果不理想。对于 产ESBLs的细菌不能单独应用B一内酰胺酶类抗生素， 需加酶抑制剂联合使用。本文提示我们产ESBLs的细菌 有逐年上升的趋势，临床上应给予重视。同时临床实验 室应将对ESBLs的检测作为常规监测。，o／。 关键词：超广谱B．内酰胺酶，头孢曲松，克拉维酸， 舒巴坦，体外抗菌活性，B．内酰胺酶抑制剂 英文摘要The 英文摘要 The study of Antibioltic Activity In vitro of 1 9 1 strains producting ESBLs ABSTRACT objectives：Recently,we have found that ESBLs extended spectrum D·lactamases is the main reason for bacteria’S tolerance to cefriaxone．To investigate the strains’ distribution over our area，the strains’type and its’ sensitivity to antibiotics，we detected 1 9 1 strains producting ESBLs isolated from patients．In the present study，we evaluated the antibacterial activity of ceftriaxone／ clavulanic against the 1 9 1 strains and compared with ceftriaxone／clavulanic and ceftriaxone／sulbutam． Methods：574 strains of Gram．negative bacterium were collected in the period of 200 1．2～2002．2．In these strains，we have proceed phenotype anolysis，tolerance detecting and have used paper agar diffused test as verification test．1 3 kinds of antibacterials were used at sensibility test．We have compared the tolerance between strains which product ESBLs and strains which don’t product ESBLs．Different doses of antibacterial were applied onto quantitative agar media which were melted and cooled at 55℃．After mixed，pour into sterile flat—panel． By this way we got drug—containing culture with descending concentration．Inoculating nature bacteria onto 3 茎茎塑墨 茎茎塑墨 一一—— the culture,incubating 1 8-24 hours at 37℃．Observe the develoDment of bacteria and measure the minimum inhibitory concentration(MIC)． Results：The percentage of ESBLs positive bacterium in 574 strains of Gram．negative bacterium is 33．28％ (191／574)，th