超广谱β-内酰胺酶细菌耐药性调查
Analysis on resistance of strains producing extended-spectrum beta-lactamases
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摘要:目的 分析134株超广谱β-内酰胺酶菌株的耐药性, 以利于药物治疗。方法 应用双纸片协同试验鉴定超广谱β-内酰胺酶菌株, 琼脂稀释法检测超广谱β-内酰胺酶细菌的最低抑菌浓度(MIC)。结果 亚胺培南敏感率85.8%, 107株菌的MIC在0.125~4.0μg/ml之间, 美洛培南敏感率94.0%, 126株菌的MIC在0.125~4.0μg/ml之间; 头孢哌酮/舒巴坦敏感率40.3%, 44株菌的MIC在0.125~16.0μg/ml之间; 哌拉西林/他唑巴坦敏感率56.0%, 59株菌的MIC在0.125~16.0μg/ml之间; 头孢西丁敏感率47.0%, 63株菌的MIC在0.125~8.0μg/ml之间; 左氧氟沙星敏感率61.9%, 83株菌的MIC在0.125~2.0μg/ml之间; 环丙沙星敏感率53.7%, 72株菌的MIC在0.125~1.0μg/ml之间; 丁胺卡那霉素敏感率64.2%, 86株菌的MIC在0.125~8.0μg/ml之间; 氯霉素、头孢噻肟、头孢吡肟、氨曲南敏感率均在40.0%以下。结论 抗菌活性最好的是碳青霉烯类药物, 加酶抑制剂的头孢哌酮/舒巴坦、哌拉西林/他唑巴坦中介耐药增加, 主要原因是临床过度使用所致, 喹诺酮类抗生素对大肠埃希菌以外的细菌抗菌活性较好。Abstract:Objective To analyse the resistance of strains producing ESBLs so as to give a better medicine therapy.Methods Strains produing ESBLs were identified by double-disk synergy test and their MIC were detected by agar dilusion test.Results The sensitivity of Imipenem was 85.8% and MIC was between 0.125-4.0μg/ml; Meropenem 94.0% and 0.125-4.0μg/ml.They had shown good antibiotic activity.Cefoperazone/Sulbactam 40.3%, MIC at 0.125-16.0μg/ml (44 strains); Piperacillin/tazobactam 56.0%, MIC 0.125-16.0μg/m(59 strains); Cefoxitin 47.0%, MIC 0.125-8.0 μg/ml(63 strains); Levofloxacin 61.9%, MIC 0.125-2.0μg/ml(83 strains); Ciproaoxacin 53.7%, MIC 0.125-1.0 μg/ml(72 strains); Amikacin 64.2%, MIC 0.125-8.0μg/ml(86 strains); Chloramphenicol, Cefotaxime, Cefepime and Aztreonam all below 40.0%.Conclusions Carbapenems had the best antibiotic activity.There were increases of intermediate resistane for Cefoperazone/sulbaetam and Piperacillin/tazobactam which have enzyme inhibitor.They have been overused in clinical may be the main reason.Quinolones have better antibiotic activity on bacteria except for Escherichia coli.
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