南方医科大学学报

南方医科大学学报 ›› 2004, Vol. 24 ›› Issue (04): 439-440,444.

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下呼吸道感染患者产超广谱β-内酰胺酶的细菌的耐药性分析

龙军, 吕苏成   

  1. 第一军医大学珠江医院检验科, 广东, 广州, 510282
  • 出版日期:2004-04-20 发布日期:2004-04-20
  • 基金资助:
    收稿日期:2003-11-24。
    基金项目:广东省医学科研课题(A20011554)
    作者简介:龙军(1967-),男,毕业于湖南医科大学,主管技师,电话:020-61648390,E-mail:LongJun327@sina.com

Drug-resistance analysis of Gram-negative bacilli producing extended-spectrum β-lactamases in lower respiratory tract infection

LONG Jun, Lü Su-cheng   

  1. 第一军医大学珠江医院检验科, 广东, 广州, 510282
  • Online:2004-04-20 Published:2004-04-20

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摘要： 目的 分析下呼吸道感染病人产超广谱β-内酰胺酶(ESBL)革兰阴性菌的发生及对10种抗菌药物耐药情况,并对临床针对性治疗ESBL耐药菌下呼吸道感染提出建议。方法 采用全自动微生物分析仪鉴定细菌及用仪器法、双纸片协同试验法和标准纸片扩散确认法,对从下呼吸道感染患者中分离出的312株革兰阴性菌作ESBL检测,比较亚胺培南等10种抗菌药物对产ESBL耐药菌抗菌作用。结果 产ESBLs耐药株占全部菌的23.1%,其中肺炎克雷伯占30.1%,大肠埃希菌占29.1%,阴沟肠杆菌占27.0%,铜绿色假单胞菌占11.3%,产酸克雷伯菌占2.5%;亚胺培南对产ESBL耐药菌表现出最强抗菌作用。结论 要注意产ESBL革兰阴性菌所致下呼吸道感染;对ESBL革兰阴性菌下呼吸道感染的治疗,亚胺培南可作为首选药物。

Abstract: Objective To analyze occurrence of Gram-negative bacteria producing extended-spectrum β-lactamase (ESBL) in patients with lower respiratory tract infection and assess their drug sensitivity to provide evidence for clinical management of lower respiratory tract infection with drug-resistant ESBL-producing bacteria. Methods A total of 312 Gram-negative bacterial strains were isolated from patients with lower respiratory tract infection and identified for the presence of ESBL by Vitek ESBL detection test and double-disk synergy tests as well as standard disk diffusion test. The effects of 10 antibacterial drugs on ESBL-producing strains were compared. Results A rate of 20.1% of the isolated strains were identified to produce ESBLs, including Klebsiella Pneumoniae, Escherichia coli, Enterobacter cloacae, Pseudomonas aeruginasa and Klebsiella oxytocla (accounting for 30.1%, 29.1%, 27.0%, 11.3%, and 2.5%, respectively, of the ESBL-producing strains). Imipenem possessed the most powerful antibacterial activity against ESBL-producing strains. Conclusions Attention should be given to lower respiratory tract infections with ESBL-producing Gram-negative bacilli, and imipenem can be the primary choice for fighting such infections.

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