1 032株产ESBLs病原菌临床分布及耐药性分析

Clinical distribution and drug resistance of 1 032 strains of ESBLs-producing pathogenic bacteria

摘要:

目的：对1 032株产超广谱β－内酰胺酶（Extend-spectrum β-lactamases，ESBLs）病原菌临床分布及耐药性进行调查，为临床合理使用抗生素提供依据。方法：对临床送检的标本按本实验室方法进行分离、培养、鉴定，药敏用最低抑菌浓度（Mini－mum inhibitory concentration，MIC）法，耐药性诊断和ESBLs检测结果均依据美国国家临床实验室标准委员会制定的操作标准进行判断。结果：3种产ESBLs菌株中大肠埃希氏菌600株、肺炎克雷伯氏菌302株、产酸克雷伯氏菌130株。大肠埃希氏菌对广谱青霉素类、所有头孢菌素类包括四代头孢、单环类、部分氨基糖苷类都有较高的耐药性，耐药率在60%~95%；肺炎克雷伯氏菌、产酸克雷伯菌对广谱青霉素类有更高的耐药性，耐药率在90%~100%，头孢类耐药率都在40%以上。结论：产ESBLs菌株耐药性高，应合理应用抗生素，控制细菌耐药性的产生，控制耐药菌株广泛流行。

Abstract:

Objective：To provide strong evidence for the rational use of antibiotics through investigating clinical distribution and drug resistance of 1 032 strains of extend-spectrum β-lactamases（ESBLs）-producing pathogenic bacteria. Methods：Clinical specimens were processed by laboratory methods for separation，cultivation and identification. Minimum inhibitory concentration（MIC） was used for antibiotic susceptibility tests. Both results of antibiotic resistance and ESBLs were assessed according to the operating standards developed by the United States National Clinical Laboratory Standards Committee. Results：There were 600 strains of Eschericha coli，302 strains of Klebsiella pneumoniae and 130 strains of Klebsiella oxytoca among the ESBLs-producing isolates. Eschericha coli showed high drug resistance to extended-spectrum penicillins，cephalosporins including the forthgeneration cephalosporin，single-ring lactams and part of aminoglycosides and the resistant rates were between 60% and 95%. While Klebsiella pneumoniae and Klebsiella oxytoca showed higher resistance to extended-spectrum penicillins and resistant rates were between 90% and 100%. Their resistance rates to cephalosporins were all above 40%. Conclusions：The ESBLs-producing pathogenic strains show high drug resistance. We should use antibiotics reasonably in order to control bacterial drug resistance and to prevent the wide prevalence of resistant strains.