摘要
目的通过对β-内酰胺酶耐药菌株在院内各科室的分布及细菌耐药性分析,为临床提供可靠而科学的治疗细菌感染的依据。方法采用法国生物-梅里埃公司生产的API系统和VITEK2系统进行细菌鉴定,采用法国生物-梅里埃公司生产的GNS-506药敏卡及双纸片协同试验法,对发生院内感染的标本中分离出的986株革兰阴性菌作ESBLs的检测,比较亚胺培南、氨基糖苷类及喹诺酮类等14种抗菌药物对ESBLs耐药菌的体外抗菌作用。结果产ESLBs耐药株占全部分离菌的33.6%,其中肺炎克雷伯菌占30.9%,绿浓杆菌.占24.9%,流感杆菌占18.3%,大肠埃希菌占11.3%,阴沟肠杆菌占8.1%,铜绿假单胞菌占5.6%醋酸钙不动杆菌5.3%;亚胺培南对铜绿假单胞菌外产ES-BLs耐药菌均表现出最强抗菌作用;头孢西丁对产ESBLs肺炎克雷伯菌及大肠埃希菌有较好的抗菌作用,其他产ES-BLs耐药菌对头孢西丁呈全部耐药;氨基糖苷类及喹诺酮类抗菌药物对产ESBLs肺炎克雷伯菌呈现出较好的抗菌作用。院内感染发生率为4.2%。感染β-内酰胺酶耐药菌株病原菌依次为肺炎克雷伯氏菌、绿浓杆菌、大肠艾希氏菌、阴沟肠杆菌、等。结论产ESBLs革兰阴性菌所致医院内部感染不容忽视;对产ESBLs革兰阴性菌医院内部感染的治疗,亚胺培南、氨基糖苷类及喹诺酮类可作为首选。提示要重视医院内感染的监测,合理使用β-内酰胺酶类抗生素,对患者采取有效的保护性措施,防止和治疗院内感染。
Objective Through to investigate the infection and bacterial drug resistant of the ESBLs bacterium conceived nosocomial spectrum, we can provide a dependable basis about how to cure bacterium to doctor. Methods The ESBLs bacterium had been identified by french API and VITEK2 system and been tested by with double face method from 986 clinical samples. We compare the drug resistance including imipenem , aminoglycesides drugs and quinolones ect. to 14 kinds of antibiotics aceordirg test. Results The ESBLs bacterium about 33.6% ,there are Klebsiella 30.9% Pyocyanosis 24.9% Bacillus Influenzae developed 18.3% coil 11.3% Enterobacter cloacae 8.1% pseudomonas aeruginesa 5.6% ;Pseudomonas 5.3 % in it. Imipenem have the best role to kill the bacterium exept , Pyocyanosisand the other ESBLs are all have drug resistance to Cefoxitin . aminoglycesides drugs and quinolones drugs ofen have the better role to the ESBLs bacterium. The rate of infection in hospital is about 4.2%. To order these bacterium is that Klebsiella, Pyocyanesis Bacillus Influenzae devdoped, coll, Enterobacter cloacae, pseudomonas acruginosa and Pseudomonas ect. Conclusion It is important that the bacterium that produced ~laetamase antibiotics can cause the infection in hospital. To cure this disease ,we can use imipenem ,aminoglycosides drugs and quinolones at first.This prompt that we must value the infection in hospital. We must use the ESBLs antibiotic reasonable to protect the benefit of patient and to cure the infection in hospital.
出处
《中国实验诊断学》
2006年第12期1458-1461,共4页
Chinese Journal of Laboratory Diagnosis
关键词
医院内感染
β-内酰胺酶耐药菌株
细菌耐药性
infection in hospital
the non-β-lactamase antibiotics（ ESBLs）
Drug resistance of bacterium
