【摘要】 目的 :了解产超广谱 β 内酰胺酶 (ESBLs)细菌的种类及分布 ;测定产酶菌对临床常用抗生素的敏感性。方法 :采用双纸片协同法和微量稀释法 (VITEKAMS 6 0GNS 5 0 6药敏卡片 )筛选产ESBLs细菌 ;用MIC微量稀释法测定产酶菌对抗生素的敏感性。结果 :从临床标本中分离出产ESBLs 6种 5 1株细菌 ,大肠埃希氏菌中产ESBLs 15 % ,肺炎克雷伯氏菌中产ESBLs 14 % ,阴沟肠杆菌中产ESBLs占 4% ,铜绿假单胞菌、不动杆菌、弗氏柠檬酸杆菌中产ESBLs小于 6 .3%。抗生素敏感试验结果表明 :各种产ESBLs细菌对亚胺培南、美洛培南均具有高的敏感性 ,且亚胺培南优于美洛培南 ;但也出现了对碳青酶烯类耐药 ;对阿米卡星敏感性较高 ;对头孢西丁敏感性因菌种不同而异。结论 :产ESBLs细菌在上述诸菌种中具有一定比例 ;产ESBLs菌感染治疗首选药物为亚胺培南、美洛培南 ,选用其他抗生素视菌种不同而定。更多还原

【Abstract】 Objectives: To investigate the species and source of the ESBLs -producing bacteria from the clinical specimen and their sensitivity to 12 commonly used antibiotics in clinic. Methods: To detect the ESBLs-producing bacteria,the double-sheets synergic method and the micro-diluent method (by VITEK AMS-60 GNS-506 antibiotic sensitivity disc) was used .The micro-diluent methods was used to measure their sensitivity to the antibiotics. Results: 51 strains in 6 species of the ESBLs -producing bacteria was isolated from the clinical specimen. These account for 15% in Escherichia coli , 14% in Klebsiella pneumoniae , 8% in Enterobacter cloacae , <6.3% in Pseudomonas aeruginosa or Acinetobacter or Citrobacter feundii . The result of antibiotics sensitivity tests showed that the ESBLs -producing bacteria are highly sensitive to imipenem and meropenem, the former superior to the latter, followed by amkacin, with different sensitivity to cefoxitin depedent on the different bacteria species. Conclusion: There is a constant proportion of the ESBLs-producing bacteria in the corresponding bacteria above. Imipenem and meropenem were preferred in the treatment of the ESBLs-producing bacteria; and other antibiotics were selected according to bacteria species.更多还原