产酶大肠埃希菌和肺炎克雷伯菌的检测及耐药性分析
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冯强

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R378.2+1 R378.99+6

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Detection of extendedspectrum betalactamases and AmpC betalactamases and analysis of antimicrobial  resistance in clinical isolated strains of Escherichia coli and Klebsiella pneumoniae
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    摘要:

    目的研究某医院产超广谱β内酰胺酶( ESBLs)和质粒AmpC酶的大肠埃希菌、肺炎克雷伯菌耐药情况。方法对2006年11月—2007年7月分离的139株大肠埃希菌和102株肺炎克雷伯菌分别采用标准纸片扩散法检测ESBLs,头孢西丁三维试验检测质粒AmpC酶;并用KB纸片扩散法进行药敏试验,根据美国临床实验室标准化委员会 2002年判断标准分析结果。结果139株大肠埃希菌产ESBLs、AmpC酶及ESBLs+AmpC酶菌株的检出率分别为48.20%、9.35%、2.88%;102株肺炎克雷伯菌产ESBLs、AmpC酶及ESBLs+AmpC酶菌株的检出率分别为55.88%、8.82%、2.94%。产ESBLs菌株对头孢菌素类、氨基糖苷类、单环酰胺类抗菌药物耐药率明显高于非产ESBLs菌株(P<0.001~0.05 )。除碳青霉烯类及头孢他啶等抗生素外,产AmpC酶菌株对二、三代头孢菌素及喹诺酮类等药的耐药率均明显增高(P<0.001~0.05 )。结论耐药酶的产生是导致细菌耐药的重要原因之一,合理使用抗菌药物对预防耐药菌的产生和控制医院感染非常重要。

    Abstract:

    ObjectiveTo study the drug resistance of extendedspectrum betalactamasesproducing and plasmidmediated AmpC betalactamasesproducing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) in a hospital. MethodsOne hundred and thirtynine strains of  E. coli and 102 strains of K. pneumoniae were collected from clinical specimens form November, 2006 to July,2007. ESBLs production was detected by the standard disk diffusion method, and AmpC production was detected by cefoxitin threedimensional test of enzymeextraction. Drug susceptibility was detected by KirbyBauer disk diffusion method, the result were analysed by American NCCLS Standard.ResultsAmong 139 strains of E.coli, ESBLsproducing, AmpC betalactamaseproducing, both ESBLs and AmpC betalactamaseproducing E.coli was 48.20%, 9.35% and 2.88% respectively; among 102 strains of K.pneumoniae, the isolation rate was 55.88%, 8.82% and 2.94% respectively. The resistant rate of ESBLsproducing strains to caphalosporins, aminoglycosides and monobactams was obviously higher than those of nonESBLsproducing strains (P<0.001~0.05), except carbapenem and ceftazime, plasmidmediated AmpC betalactamaseproducing strains revealed a high drug resistance to the second and third generation cephalosporins and quinolones (P<0.001~0.05). ConclusionProduction of ESBLs and AmpC  in bacteria are important factors in  drug resistance. More attention should be paid to the use of antimicrobial agents and control of nosocomial infection.

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冯强.产酶大肠埃希菌和肺炎克雷伯菌的检测及耐药性分析[J]. 中国感染控制杂志,2009,8(1):44-47.
FENG Qiang. Detection of extendedspectrum betalactamases and AmpC betalactamases and analysis of antimicrobial  resistance in clinical isolated strains of Escherichia coli and Klebsiella pneumoniae[J]. Chin J Infect Control, 2009,8(1):44-47.

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  • 收稿日期:2008-02-20
  • 最后修改日期:2008-04-22
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  • 在线发布日期: 2009-01-30
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