产超广谱β-内酰胺酶肺炎克雷伯菌和大肠埃希菌的分布及其耐药性分析.docVIP

精品论文 参考文献 产超广谱β-内酰胺酶肺炎克雷伯菌和大肠埃希菌的分布及其耐药性分析 申明霞 王敬衍 (山东省济宁市金乡人民医院 272200） 【中图分类号】R446.5 【文献标识码】A 【文章编号】1672-5085（2010）34-0074-02 【摘要】目的 了解某院产超广谱beta;-内酰胺酶大肠埃希菌和肺炎克雷伯菌的分布和耐药性特点，指导临床合理使用抗生素。方法 对某院2007年1月-2010年1月间临床送检各类标本进行培养，用CLSI/NCCLS推荐的表型确证法检测其产超广谱beta;-内酰胺酶,采用K-B纸片琼脂扩散法进行药敏试验,分析产超广谱beta;-内酰胺酶菌株的分布及耐药性。结果 2007 年产超广谱beta;-内酰胺酶菌检出率为16.20%，2008年为25.80%，2009年为40.96%。标本主要分布于痰，咽拭子和尿中。产超广谱beta;-内酰胺酶菌耐药性有明显的逐年增高趋势。它对亚胺培南呈高度敏感,对哌拉西林/他唑巴坦等联合酶抑制剂的抗生素耐药率较低,对三代头孢菌素磺胺类和喹诺酮类等抗菌药物均出现较高耐药。结论 产超广谱beta;-内酰胺酶的大肠埃希菌和肺炎克雷伯菌分布在不同的标本中,其检出率和耐药性正在逐年增强，碳青霉烯类抗生素亚胺培南是治疗产超广谱beta;-内酰胺酶菌株感染的较佳药物。 【关键词】产超广谱beta;-内酰胺酶 大肠埃希菌 肺炎克雷伯菌 耐药性 Distribution and drugresistance analysis of Escherichiacoli and Klebsiellapneumoniae producing extended spectrumbeta-lactamases 【Abstract】 To investigate the distribution and drugresistance of E ective scherichiacoli and Klebsiellapneumoniae producing extended spectrum beta-lactamases(ESBLs) in hospital. Methods ESBLs was detected by CLSI/NCCLS phenotypic confirmatory testing E.coli and K.pneumoniae which were isolated from Jan 2007 to Jan 2010 in the hospital. Antimicrobial susceptibility was tested by Kir by-B auer method. The distribution and drugresistance of strains producing ESBLs was analyzed. Results The total detection rate of E.coli and K.pneumoniae producing ESBLs was 16.20% in the year of 2007. The total detection rate of E.coli and K.pneumoniae producing ESBLs was 25.80% in the year of 2008. The total detection rate of E.coli and K.pneumoniae producing ESBLs was 40.96% in the year of 2009, respectively. The distribution of wards mainly came from pulmonarydisease, u-rology and ICU ward. The strains producing ESBLs were very susceptible to imipenem,and relatively Susceptible to piperacillin/tazobactam, cefoperazone/ tazobactam. The resistance rate of the strains producing ESBLs was high to other antimicrobial. Conclusion The E.coli and K.pneumoniae strains producing ESBLs distribute various kinds of specimens from different wards. Im