产超广谱b-内酰胺酶肺炎克雷伯菌与大肠埃希菌耐药性分析

Analysis of Drug Resistance of ESBLs-product Klebsiella Pneumoniae and Escherichia Coli

关键词:  超广谱β-内酰胺酶  耐药性  抗菌药物  肺炎克雷伯菌  大肠埃希菌

Key words:  extended-spectrum β-spectrum lactamases  drug resistance  antimicrobial drugs  Klebsiella pneumoniae  Escherichia coli

摘要:

目的 了解临床产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌和大肠埃希菌对常见抗菌药物的耐药变化，为临床合理使用抗菌药物提供参考。方法 收集2006—2011年医院各类临床标本中分离的肺炎克雷伯菌和大肠埃希菌，采用Vitek-32全自动微生物鉴定仪和Vitek-32配套试剂GNS-448卡进行鉴定和药敏试验，试验方法与判定标准按美国临床实验室标准化委员会(CLSI)的标准判定。结果 2006—2011年产ESBLs的肺炎克雷伯菌和大肠埃希菌总检出率分别为57.80%(1 563株)和 30.55%(2 506株)。亚胺培南对ESBLs阳性肺炎克雷伯菌和ESBLs阳性大肠埃希菌高度敏感。结论 6年来肺炎克雷伯菌和大肠埃希菌对临床常用的抗菌药物表现出较高耐药性。应加强对肺炎克雷伯菌和大肠埃希菌的ESBLs监测，有效控制产ESBLs肺炎克雷伯菌和大肠埃希菌的散播以及耐药基因的传播。

Abstract:

OBJECTIVE To investigate the trend of antibiotic resistance of extended-spectrum β-lactamases(ESBLs) producing in our hospital, and to provide a guidance for clinical rational use of antibiotics. METHODS Klebsiella pneumoniae and Escherichia coli strains were collected, which were isolated from patients in clinical in 2006-2011. Bacterial susceptibility testing were detected by Vitek-32 automatic identification system. The results were evaluated based on Clinical and Laboratory Standards Institude(CLSI). RESULTS All of 1 563 strains of K. pneumoniae were considered ESBLs, the positive rate was 57.80%. All of 2 506 strains Escherichia coli considered ESBLs, the positive rate was 30.55%. Imipenem should be considered to be a preferred antibiotic when used on ESBLs producing K. pneumoniae and Escherichia coli infected cases. CONCLUSION ESBLs K. pneumoniae and Escherichia coli have the multidrug-resistant phenomenon. Surveillance should be intensified, so as to avoid the increasing, diffusive and popular of ESBLs-producing bacteria.