产ESBLs的大肠埃希菌和肺炎克雷伯菌的耐药性分析

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

    • 摘要: 目的 探讨我院产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌的耐药性变化,为临床合理使用抗菌药物提供参考依据。 方法 分析我院2008—2009年从临床送检的各类标本中分离得到的大肠埃希菌和肺炎克雷伯菌,采用MIC法进行药敏试验,双纸片确诊试验测定产ESBLs菌株。 结果 2008年分离的764株大肠埃希菌中,产ESBLs的有312株,占40.8%;356株肺炎克雷伯菌中,产ESBLs的有133株,占37.4%。2009年分离得到的499株大肠埃希菌中,产ESBLs的有246株,占49.3%;298株肺炎克雷伯菌中,产ESBLs的有107株,占35.9%。产ESBLs菌株的耐药性显著高于非产ESBLs菌株(P<0.05)。2009年产ESBLs的大肠埃希菌和肺炎克雷伯菌对氨曲南、头孢菌素类三代、四代药物的耐药率明显高于2008年(P<0.05),对喹诺酮类药物的耐药率低于2008年(P<0.05)。2009年产ESBLs肺炎克雷伯菌对亚胺培南的耐药率较2008年上升了15.9%(P<0.05)。 结论 产ESBLs的大肠埃希菌和肺炎克雷伯菌呈多重耐药现象,必须加强耐药监测,防止产ESBLs菌株的增长、扩散与流行。

       

      Abstract: OBJECTIVE To investigate the trend of antibiotic resistance of extend-spectrum β-lactamases(ESBLs) producing Escherichia coli and Klebsiella pneumoniae in our hospital, and to provide a guidance for clinical rational use of antibiotics. METHODS Escherichia coli and Klebsiella pneumoniae strains were collected, which were isolated from patients in clinical in 2008-2009. Bacterial susceptibility testing were detected by MIC methods and ESBLs-producing strains were detected by double-disc diffusion confirming test. RESULTS In 2008, 312 of 764 strains of Escherichia coli were considered ESBLs, the rate of ESBLs were 40.8%; 133 of 356 strains of Klebsiella pneumoniae were considered ESBLs, the rate of ESBLs were 37.4%. In 2009, 246 of 499 strains of Escherichia coli were considered ESBLs, the rate of ESBLs were 49.3%; 107 of 298 strains of Klebsiella pneumoniae were considered ESBLs, the rate of ESBLs were 35.9%. The resistance rate of ESBLs- producing strains were significantly higher than that of ESBLs non-producing strains(P<0.05). The resistance rate of ESBLs-producing strains to aztreonam and cephalosporin were higher in 2009 than in 2008(P<0.05). The resistance rate of ESBLs-producing strains to quinolones were lower in 2009 than in 2008(P<0.05). The resistance rate of ESBLs-producing strains of Klebsiella pneumoniae to imipenem was increased by 15.9% in 2009(P<0.05). CONCLUSION ESBLs producing Escherichia coli and Klebsiella pneumoniae have the multidrug-resistant phenomenon, surveillance should be intensified, so as to avoid the increasing, diffusive and popular of ESBLs-producing bacteria.

       

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