产ESBLs大肠埃希菌、肺炎克雷伯菌的分布及耐药性分析 FREE

Distribution and drug resistance of ESBLsproducing Escherichia coli and Klebsiella pneumonia in a hospital FREE

摘要:

目的了解某院大肠埃希菌、肺炎克雷伯菌产超广谱β内酰胺酶（ESBLs）的分布及耐药特点。方法对该院2007年10月—2008年9月各科送检标本分离的大肠埃希菌和肺炎克雷伯菌，采用双纸片扩散法进行ESBLs确证试验，KB纸片扩散法进行药敏试验。结果分离出大肠埃希菌766株，其中产ESBLs株443株（57.83%）；肺炎克雷伯菌632株，产ESBLs株355株（56.17%）。产酶菌株主要分离自痰（557株，69.80%）、尿（149株，18.67%）等标本。产ESBLs菌对亚胺培南/西司他丁、美罗培南、头孢哌酮/舒巴坦敏感性高，对第一～三代头孢菌素类几乎全部耐药，对喹诺酮类、氨基糖苷类等存在交叉耐药。结论产ESBLs菌感染严重，以下呼吸道感染最多，其次为泌尿道感染；耐药率较高，亚胺培南/西司他丁、美罗培南、头孢哌酮/舒巴坦对其保持较高的抗菌活性。

Abstract:

To study the distrubution and drugresistance of Escherichia coli (E. coli) and Klebsiella pneumonia (K. pneumonia) which  produced extendedspectrum betalactamases(ESBLs) in a hospital.MethodsThe doubledisk synergy test was performed to detect ESBLsproducing strains and antimicrobial susceptibility was determined by disk diffusion test in specimens collected from  patients from October， 2007 to September， 2008.Results443 of  766(57.83%) E. coli strains produced ESBLs； 355 of 632 (56.17%) K. pneumonia strains produced ESBLs. Most ESBLsproducing strains were isolated from  sputum (557 strains, 69.80%) and urine (149 strains,18.67%). ESBLsproducing strains were susceptible to imipenem／cilastatin, meropenem and cefoperazone/sulbactam, but resistant to almost all the first to third generation cephalosporins, and had cross resistance among  quinolones and aminoglycosides.ConclusionInfections caused by ESBLsproducing strains are serious, majority are lower respiratory tract infection, the next is urinary tract infection; drugresistance is high, imipenem/cilastatin, meropenem and cefoperazone/sulbactam have high antimicrobial activity on ESBLsproducing strains.