摘要
目的了解我院产超广谱-内酰胺酶ESBLs的大肠埃希菌和肺炎克雷伯菌的耐药性为临床合理使用抗菌药物提供依据。方法 2013年1~12月从本院住院患者的各类临床标本,采用CLSI推荐的双纸片协同试验;用头孢他啶、头孢他啶/克拉维酸和头孢噻肟、头孢噻肟/克拉维酸确证试验确认和ESBLs确证试验进行ESBLs的检测。结果大肠埃希菌、肺炎克雷伯菌产ESBLs菌株的检出率分别为58.6%和41.3%;产ESBLs菌株较不产ESBLs菌株表现为对抗菌药物明显高的耐药率,除个别抗菌药物外,两者差异具有显著性P值<0.05,以及高多重耐药率;产ESBLs的大肠埃希菌、肺炎克雷伯菌对亚胺培南耐药率最低,分别是4.5%和2.1%,其次是阿米卡星、头孢哌酮/舒巴坦,对其他抗菌药物的耐药率均>70%。结论我院产ESBLs大肠埃希菌和肺炎克雷伯菌与高发地区相近,但是在我院建立多药耐药菌监测制度后,产ESBLs的菌发生率出现下降。
Objectives To study drug resistance of ESBLs-producing Klebsiell apneumoniae and E scherichiacoli,to provide basis for rational application of antibiotics. Methods Isolation, cultivation, identification, drug-sensitivity tests, and confirmation of ESBLs-producing bacteria were done for all t he bacterial specimens collected from our hospital in 2013. Susceptibility testing was performed by disk diffusion( K-B) method. Results The constituentratios of E. coli and K. p neumoniae, which could produce ESBLs, were 58.6% and 41.3%, respectively at our hospital in 2013. The MDR( multi-drug-resistance) rat e of ESBLs-producing strains was higher than that of strains no producing ESBLs( P < 0. 05). The ESBLs-producing strains of E. coli and K. pneumoniae were sensitive to imipenem, and t heir resistance rates to imipenem were 4. 5% and 2. 1%, respectively. The resistance rates of ESBLs-producing E. coli strains to amikacin, cefoperazone/ sulbactam( Sulperazon) were 24. 6% to 31. 4%. The resistance rate of K. p neumoniae strains t o Sulperazon was 42. 5%, and over 70% to other antibiotics. Conclusions The incidences of ESBLs-producing K. p neumoniae and E. coli in Tibet Autonomous Region People's Hospital are similar to that of high occurrence areas. Fortunately the rate is dropped since the multiple-drug bacteria monitoring system is established.
出处
《西藏医药》
2014年第2期6-8,共3页
Tibetan Medicine
关键词
产超广谱内酰胺酶
大肠埃希菌
肺炎克雷伯菌
耐药性
Ext ended-spectrum -Lactamases
Escherichia coli
Klebsiella p neumoniae
Drug resistance
