【摘要】 目的:探讨新生儿病房产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌和大肠埃希菌耐药特点,指导临床用药。方法:经痰、血、脑脊液培养确诊为产ESBLs肺炎克雷伯菌及大肠埃希菌引起新生儿感染23例,分析药敏试验结果及治疗情况。结果:产ESBLs菌对亚胺培南普遍敏感,对舒普深耐药率低,肺炎克雷伯菌耐药率为36.36％,大肠埃希菌为25.0％,对头孢他啶、头孢曲松、头孢噻肟及氨曲南耐药率高达75％～100％,且部分体外敏感菌株在体内却表现出临床意义的耐药,对磺胺类、氨基糖甙类、氟喹诺酮类均表现出较高的耐药性。结论:亚胺培南及含β-内酰胺酶抑制剂复合物为新生儿病房产ESBLs菌感染的首选药物。更多还原

【Abstract】 Objective: To study characteristics of antibiotic resistance of Klebsiella pneumoniae and Escherichia coli producing extended-spectrum beta-lactamases in newborn ward, and help to select antibiotic drugs. Methods: The sputum, blood and cerebrospinal fluid were cultured in 23 cases of infected newborn. The infection was caused by Klebsiella pneumoniae and Escherichea coli producing extend-spectrum beta-lactamases, then, the results of susceptibility test and treatment were analysed. Results : The ESBLs-producing strains are sensitive to imipenem, and low in the artibiotic resistance rate of sulperazon, the antibiotic resistance rate is about 36.36% in Klebsiella pneumoniae and 25.00% in Escherichia coli. However, the antibiotic resistance rate is above 80% - 100% in ceftazed-inie, ceftriaxone, cefotaxime, aztreonam and the partially sensitive strains out of body put up antibiotic resistance inside. The ESBLs-producing strains have high antibiotic resistance to sulfonamides, aminoglycosides, quinolones. Conclusion : Imipenem and β-laclama/β-lactamase inhibitor combinations are the first selected drugs in treating newborn infection caused by producing extended-speclum beta-lactomases strains.更多还原