摘要
目的了解大肠埃希菌的临床分布及其对常用抗菌药物的耐药情况,为临床抗菌药物的使用提供依据。方法应用法国生物梅里埃公司生产的API鉴定卡进行菌株鉴定,ATB药敏卡进行药敏试验,用加酶抑制剂增强试验纸片确证法进行ESBLs的确证,并对药敏结果进行分析。结果在102株大肠埃希菌中,尿液标本分离率最高(56/102),其次是痰标本(34/102),脓液(10/102),胆汁和血液(各1/102),共检出产ESBLs大肠埃希菌36株,阳性率为35%。产ESBLs大肠埃希菌对美罗培南和亚胺培南的耐药率均为0,其他抗菌药耐药率为环丙沙星94%,头孢吡肟76%,复方新诺明75%,庆大霉素67%,妥布霉素64%,乙基西梭霉素61%,阿米卡星28%,而对所有青霉素类、头孢菌素一代、二代和三代耐药率高达100%。产ESBLs菌株对抗菌药物的耐药率大部分高于不产ESBLs菌株。不产ESBLs菌株耐药率最高前三位是阿莫西林(A群青霉素)91%,替卡西林88%,头孢噻吩/1代82%;其他抗菌素(头孢西丁,头孢噻肟/3代,乙基西梭霉素,阿莫西林+棒酸,头孢吡肟,哌拉西林+他唑巴坦,头孢他定,阿米卡星)的耐药率均低于30%。结论大肠埃希菌产ESBLs株与非产ESBLs株对抗菌药物的耐药程度不一致,ESBLs的检测对于指导临床治疗非常重要,临床医生应根据药敏结果选择敏感性抗菌药物进行治疗。
Objective To investigate the clinical distribution and drug resistance of Escherichia coli, providing evidences for the clinical usage of antibacterial agents. Methods API identification cards （France’s BioMerieux） are used to identified bacterial strains. ATB is used for drug sensitivity test. Enhancing Kirby-Bauer method with enzyme-inhibitor is used to corroborate the ESBLs strains. All the results have been analyzed. Re-sults Among the 102 strains of E. coli,the isolation rate of urine is the highest（56 /102）,then the next is the rate of sputum（34 /102）,liquor puris（10 /102）,bile and blood（1 /102）. 36 strains of ESBL-producing E. coli are identified,with a positive rate of 35% . The resistance rates of ESBL-producing E. coli strains to meropenem and imipenem are 0,ciprofloxacin is 94% ,cefepime is 76% ,SMZ-TMP is 75% ,gentamicin 67% ,nebcin 64% , netilmicin 61% ,amikacin 28% . And the resistance rates to all penicillins and cephalosporin I,II,III reach up 100% . The resistance rates of most of the ESBL-producing strains are higher than the non-ESBL-producing strains,the top three of which are amoxicillin（91% ）,ticarcillin（88% ）,cefalotin（82% ）. Then the other antibi-otics （including cefoxitin,cefotaxime,netillmicin,amoxicillin ＋ clavulanic acid,cefepime,piperacillin ＋ tazobac-tam,ceftazidime,amikacin） have an average resistance rate which is less than 30% . Conclusion Given the in-consistency of the drug resistance between the ESBL-producing strains and the non-ones,it plays a very impor-tant role to identify the ESBL-producing strains for directing the clinical treatment. Clinicians should choose the sensitive antibiotics according to the drug sensitivity reports.
出处
《中国现代药物应用》
2010年第7期7-9,共3页
Chinese Journal of Modern Drug Application
关键词
大肠埃希菌
超广谱Β-内酰胺酶
药敏分析
Escherichia coli
Extended-spect rumβ-lactamases （ESBLs）
Drug susceptibility analysis
