摘要
目的了解本地区ICU分离的产ESBLs大肠埃希菌和肺炎克雷伯菌的分布及对常用抗菌药物的耐药性,为临床抗菌药物的合理使用提供依据。方法采用K-B纸片扩散法,检测2013年-2015年ICU感染类标本分离的无重复的778株大肠埃希菌和570株肺炎克雷伯菌的耐药情况,并对结果进行统计分析。结果 2013年-2015临床标本中产ESBLs大肠埃希菌和肺炎克雷伯菌的检出率分别为52.96%和44.74%,ICU产ESBLs大肠埃希菌对美罗培南、亚胺培南、阿米卡星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦的耐药率为0.00%～30.34%。产ESBLs肺炎克雷伯菌对美罗培南、亚胺培南、阿米卡星、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦的耐药率为0.00%～23.53%。ICU产ESBLs菌株耐药率明显高于非产ESBLs菌株,差异有统计学意义（P〈0.05）。结论 ICU产ESBLs大肠埃希菌与肺炎克雷伯菌对各类抗菌药物呈现不同程度耐药,并具多药耐药特点,碳青霉烯类仍是最敏感的药物;应加强产ESBLs菌株的监测及耐药性分析,以指导临床合理应用抗菌药物,对控制产ESBLs菌株的播散以及耐药基因的传播具有重要意义。
Objective To investigate the distribution and resistance of ICU isolated ESBLs producing Escherichia coli and Klebsiella pneumoniae to commonly used antibiotics, so as to provide the basis for the rational use of antimicrobial drugs.Methods K-B diffusion method was used to detect the drug resistance of 778 strains of Escherichia coli and 570 strains of Klebsiella pneumoniae isolated from ICU infected samples from 2013 to 2015,and the results were statistically analyzed.Results During 2013-2015 detection rate of ESBLs in clinical specimens of Klebsiella pneumoniae and Escherichia coli were52. 96% and 44. 74%,ICU ESBLs producing Escherichia coli to meropenem,imipenem,A Mika star,piperacillin / tazobactam,cefoperazone / sulbactam was within 0. 00%-30. 34%. That of ESBLs-producing Klebsiella pneumoniae to meropenem,imipenem,amikacin,piperacillin / tazobactam,cefoperazone / sulbactam was within 0. 00%-23. 53%. The resistance rate of ICU producing ESBLs strains was significantly higher than that of non-ESBLs-producing strains,the difference was statistically significant（ P〈0. 05）. Conclusion ICU ESBLs-producing Escherichia coli and Klebsiella pneumoniae for all types of antibiotics showed varying degrees of resistance and multidrug resistance characteristics,carbapenem is still the most sensitive drug;ESBLs-producing strains should be conducted to strengthen monitoring and analysis of drug resistance to guide clinical rational use of antimicrobial drugs,which is vital for controlling the spread of resistance genes and ESBLs strains.
出处
《中国卫生检验杂志》
CAS
2016年第11期1658-1660,共3页
Chinese Journal of Health Laboratory Technology
关键词
ICU
超广谱Β-内酰胺酶
大肠埃希菌
肺炎克雷伯菌
耐药性
ICU
Extended-spectrum β-spectrum lactamases
Escherichia coli
Klebsiella pneumoniae
Drug resistance
