摘要
目的 研究下呼吸道感染患者中大肠埃希菌和肺炎克雷伯菌产超广谱 β 内酰胺酶 (ESBLs)及产ESBLs菌株的药敏情况。方法 收集 2 0 0 2年 1月至 2 0 0 3年 12月我院下呼吸道感染患者中分离出的大肠埃希菌和肺炎克雷伯菌 137株 ,用表型确证试验检测ESBLs;用Kirby Bauer琼脂扩散法作药物敏感试验。 结果 137株大肠埃希菌和肺炎克雷伯菌中 ,共检出产ESBLs菌 84株 ,检出率为 6 1.31% ,其中大肠埃希菌 75 .5 1%、肺炎克雷伯菌 5 3.4 1% ;对哌拉西林、哌拉西林 /他唑巴坦、氯霉素、环丙沙星、复方磺胺甲基异 口恶唑、亚胺培南和美罗培南耐药率差异无统计学意义 ,产ESBLs菌株对其他 13种抗生素的耐药率均显著高于非产ESBLs菌株 (P≤ 0 .0 1) ,亚胺培南和美罗培南的敏感率最高为 10 0 %。结论 下呼吸道感染患者中大肠埃希菌和肺炎克雷伯菌产ESBLs情况严重 。
Objective To investigate extended-spectrum β-lactamases(ESBLs) production in clinical isolates of Escherichia coli(E.coli) and K lebsiella pneumoniae(K.pneumoniae) isolated from the patients with lower respiratory tract infection,and the sensitivity of ESBLs-producing strains to commonly used antibiotics.Methods Phenotypic confirmatory test was used to detect ESBLs in 137 strains of E.coli and K.pneumoniae isolated from the patients with lower respiratory tract infection between Jan 2002 to Dec 2003; Kirby-Bauer agar diffusion method was used to judge drug sensitivity.Results About 61.31%(84/137) strains were considered ESBLs bacteria by phenotypic confirmatory test.The prevalence of ESBLs in isolates of E.coli and K.pneumoniae was respectively 75.51% and 53.41%.Except piperacillin,piperacillin/tazobactam,chloromycetin,ciprofloxacin,sulfanilamide,imipenem and meropenem,the resistant rates of ESBLs-producing strains to other 13 antibiotics were much higher than those of non-ESBLs-producing strains(P≤ 0.01).The sensitive rates of imipinem and meropenem to ESBLs-producing strains were 100%.Conclusions The prevalence of ESBLs was high in clinical isolates of E.coli and K.pneumoniae from the patients with lower respiratory tract infection.The resistant rates of ESBLs-producing strains to most antibiotics were higher than those of non-ESBLs-producing strains.Carbopenems were the most effective antibiotics to infections caused by ESBLs-producing strains.
出处
《临床荟萃》
CAS
北大核心
2004年第22期1283-1285,共3页
Clinical Focus
关键词
呼吸道感染
Β-内酰胺酶类
大肠埃希菌
肺炎克雷伯菌
抗药性
respiratory tract infections
beta-lactamases
Escherichia coli
Klebsiella pneumoniae
drug resistance
