摘要
目的：了解婴幼儿社区获得性肺炎（CAP）产超广谱β-内酰胺酶（ESBLs）菌的分布及耐药情况。方法：选取2013年1-12月我院收治的婴幼儿CAP患儿2 526例,取痰标本送细菌培养,药敏试验采用琼脂扩散敏感试验（K-B法）。结果：2 526例患儿中痰培养检出产ESBLs菌173株（检出率6.85%）,其中大肠埃希菌89株、肺炎克雷伯菌56株、阴沟肠杆菌14株、产气肠杆菌10株、铜绿假单胞菌4株（产酶率分别为55.3%、56.6%、41.2%、29.4%、18.2%）;产ESBLs菌的检出率在3个月内的小婴儿明显高于3个月以上患儿（P均〈0.01）;产ESBLs菌对氨苄西林、头孢唑林、头孢呋辛、头孢噻肟高度耐药（耐药率85.55%~100%）,对头孢他啶、头孢吡肟、氨曲南中度耐药（耐药率43.35%~58.38%）,对头孢西丁、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南敏感;产ESBLs菌的耐药率明显高于非产ESBLs菌（P〈0.01）。结论：婴幼儿CAP产ESBLs菌以大肠埃希菌、肺炎克雷伯菌为主,其检出率与年龄密切相关,3个月内的小婴儿感染率高,对临床常用青霉素类、头孢菌素类抗生素大部分耐药,对头霉素类及酶抑制剂复合制剂大部分敏感,对碳青霉烯类抗生素完全敏感。
Objective： To investigate the distribution and drug resistance of producing extended spectrum β-1actamases （ESBLs） bacteria in infants with community-acquired pneumonia （CAP）. Methods： Sputum was extracted from 2,526 cases of hospitalizedinfants collected from January 2013 to December 2013, and microbial sensitivity test was performed with agar diffusion sensitivity test. Results： From all the infants, 173 producing ESBLs bacteria were isolated （the detection rate of pathogen was 6. 85% ）, there were Escherichia coil 89 strains, KlebsieUa pneumoniae 56 strains, Acinetobacbter baumannii 14 strains, Enterobacter aerogenes 10 strains, Pseudomonas aeruginosa 4 strains （ the rate of enzyme production were 55.3%, 56. 6%, 41.2%, 29.4% , 18.2% ）. The detection rate of producing ESBLs bacteria was obviously higher in infants aged ~〈 3 months than in those aged above 3 months （P〈0. 01 ）. Producing ESBLs bacteria were highly resistant to ampicillin cefazolin, cefuroxime, cefotaxime （the resistant rate was between 85.55% and 100. 0% ）, and they were moderate resistant to ceftazidime, cefepime, aztreonam （the resistant rate was between 43.35% and 58. 38% ）, but they were sensitive to the cefoxitin, cefoperazone/sulbactam, piperacillin/tazobactam, imipenem. The resistant rates of producing ESBLs bacteria were obviously higher than non-producing ESBLs bacteria （P〈0. 01 ）. Conclusion： The Escherichia coil and Klebsiella pneumoniae are main bacteria of producing ESBLs bacteria in infants with CAP. The detection rate of producing ESBLs bacteria is correlated closely with ages, the infection rate is high in infants aged ≤ 3 months. Producing ESBLs bacteria are over partial resistant to the penicillins and eephalosporins with clinical commonly used, but over partial susceptibility to cephamycins and enzyme inhibitors, and full susceptibility to carbopenems.
出处
《儿科药学杂志》
CAS
2015年第1期31-34,共4页
Journal of Pediatric Pharmacy
关键词
婴幼儿
社区获得性肺炎
超广谱Β-内酰胺酶
耐药分析
Infants
Community-acquired pneumonia
Extended spectrum β-lactamases
Resistance analysis
