摘要
目的探讨泰安市产超广谱β-内酰胺酶(ESBLs)和质粒AmpC酶肺炎克雷伯菌的耐药性。方法2005年1月至2006年7月我院临床分离的肺炎克雷伯菌251株,用Kirby-Bauer法进行药敏试验,根据NC-CLS2002年判断标准分析结果。结果251株肺炎克雷伯菌中检出产ESBLs和高产AmpC酶154株,检出率61.4%,其中单产ESBLs143株,单产AmpC酶8株,同时产AmpC酶和ESBLs3株,总检出率分别为57.0%,3.19%和1.20%。其中3株同时产AmpC酶和ESBLs的肺炎克雷伯菌对头孢菌素、酶抑制剂、氨曲南、头孢西丁都耐药,1株对亚胺培南耐药。单产ESBLs肺炎克雷伯菌对头孢曲松、头孢噻肟、左氧氟沙星耐药率在70%以上,对美罗培南、亚胺培南敏感性好。单产AmpC酶的肺炎克雷伯菌对头孢菌素,酶抑制剂的抗菌药物都耐药,对亚胺培南,头孢吡肟敏感。结论产ESBLs和高产AmpC酶是导致肺炎克雷伯菌耐药的两类主要酶,产酶株对多种抗菌药物耐药,对美罗培南、亚胺培南敏感性好.
Objective： to discuss Antimicrobial resistance of extended- spectrun β -lactamases and material particle AmpC in KlebsieUa pneumoniae. Method： Kirby - Bauer diffusion method was used in susceptibility testing and ESBLs and AmpC producers were detected by NCCLS2002 in KlebsieUa pneumoniae. Results ： The prevalence of ESBLs and AmpC producers were 61.4%. 143 strains produce ESBLs and the resistance rates to Ceftriaxone,Cefotaxime,Levofloxacin were 70% ,but all of them were susceptibility to Meropenem,Imipenem. 8 strains produce AmpC and all of them were resistant to cephalesporins,β- lactams/β- lactam ase inhibitors, but all of them were susceptibility to Cefepime, Imipenem . 3 strains produce ESBLs and AmpC and all of them were resistant to cephalosporins, β -lactams/β -laetam ase inhibitors, Aztreonam,Cefoxitinand one of them was resistant to Imipenem. Conclusion： the ESBLs and AmpC enzyme causes to the drug resistance of pneumonia gram Reber fungus which resistanced many kinds of antibiotics.
出处
《泰山医学院学报》
CAS
2006年第7期646-648,共3页
Journal of Taishan Medical College
关键词
AMPC酶
超广谱Β-内酰胺酶
肺炎克雷伯菌
耐药性
AmpC enzyme
extended - spectrum β - laetamases
Klebsiella pneumoniae
Antimicrobial resistance
