【摘要】 目的　了解第 3 ,4代头孢菌素的使用及其与细菌产超广谱 β 内酰胺酶的关系 ,以指导临床合理用药。方法　选取江汉大学附属医院确诊为下呼吸道感染的住院患者 44 3例 ,对每例患者送检的晨痰标本经涂片筛检合格后再培养分离 ,共培养出 473株致病菌 (真菌除外 )。采用Kirby Bauer扩散法进行药敏分析。对每例患者使用第 3 ,4代头孢菌素情况进行统计。结果　 2 0 0 1,2 0 0 2 ,2 0 0 3年第 3 ,4代头孢菌素使用率分别为 3 6 67% ,41 46%及 46 67% ;大肠埃希菌产超广谱 β 内酰胺酶分别为 17 65 % ,3 8 0 0 % ,3 9 0 2 % ;肺炎克雷白杆菌产超广谱 β 内酰胺酶分别为 19 2 3 % ,43 90 % ,44 74%。结论　第 3 ,4代头孢菌素的使用率增加 ,细菌产超广谱 β 内酰胺酶亦逐年增加。更多还原

【Abstract】 Objective To investigate the relation between application of the third and the fourth generation cephalosporins and multi-antibiotic-resistant bacteria with extended-spectrum- β-lactamases (ESBLs) ,then improve rational drug therapy. Method We chose 443 inpatients with lower respiratory tract infections (LRTI).The morning phlegm samples from the patients were collected and cultured.There were 473 germs (except fungi) separated.The drug sensitivity of the germs were analyzed by Kirby-Bauer method, and the applications of the third and the fourth generation cephalosporins in the patients were recorded. Results In 2001, 2002 and 2003, the rates of the third and the fourth generation cephalosporins application were 36.67%, 41.46% and 46.67%, respectively, the rate of E.coil with ESBLs were 17.65%, 38.00%, 39.02% ,respectively , and the rate of Klebsiella spp with ESBLs 19.23%, 43.90% and 44.74%, respectively. Conclusion The increasing rate of multi-antibiotic-resistant bacteria with ESBLs is companied by the increasing use of the third and the fourth generation cephalosporins.更多还原