【摘要】 目的　探讨氟氯西林、克拉维酸与超广谱头孢菌素协同法 (双抑制剂扩散协同法 ,DIDST)检测AmpCβ 内酰胺酶 (AmpC BLA)和超广谱 β 内酰胺酶 (ESBLs)的应用价值。 方法　氟氯西林和克拉维酸分别作为AmpC BLA和ESBLs的抑制剂。采用DIDST和双纸片增效试验、双纸片协同试验和头孢西丁三维试验同时检测 5 6株革兰阴性杆菌的AmpC BLA和ESBLs。结果　DIDST检出ESBLs 2 0株 (35 .71% )、AmpC BLA 12株 (2 1.43% )和ESBLs+AmpC BLA 1株 (1.78% ) ;双纸片协同试验中 ,纸片相距 2 5mm仅检出 15株 (2 6 78% ) ,距离减至 2 0mm ,又检出 5株 ,阳性检出率提高 8.93% ;双纸片增效试验检出ESBLs 2 0株 (35 70 % ) ;三维试验检出AmpC BLA 12株。DIDST与头孢西丁三维试验、双纸片协同试验和双纸片增效试验总符合率达 10 0 %。结论　DIDST在一个平板上可同时检测ESBLs和AmpC BLA ,方法准确、简易 ,适于各级医院推广应用更多还原

【Abstract】 Objectives To consider the reliability of using flucloxacillin (FCC) and clavulanic with extended spectrum cephalosporin synergy method (double inhibitors diffuse synergy test, DIDST) to detect AmpC β lactamases (AmpC BLA) and extended spectrum β lactamases (ESBLs). Method The FCC and clavulanic were regarded as the inhibitors of AmpC BLA and ESBLs respectively. The disks of ceftriaxone and cefepime were placed 20 mm away from the inhibitors, the disks of cefotaxime and the inhibitors were 25 mm apart. DIDST with a double disk synergy test, a cefoxitin three dimensional test, and a double disk enhancement test detected AmpC BLA and ESBLs in 56 strains of gram negative bacilli at the same time. Results 20 (35.71%) strains of ESBLs, 12 (21 43%) for AmpC BLA and 1 (1.78%) for ESBLs+AmpC BLA were found using DIDST, in 56 strains of G - B. During the double disk synergy test was used for ESBLs, 15 strains were found when the distance of the disks was within 25 mm, another 5 strains were found when the distance decreased to 20 mm. Twenty strains of ESBLs were found using the double disk enhancement test, and 12 strains of AmpC using the cefoxitin three dimensional test. The result of DIDST was similar to that of other three kinds of test. Conclusions DIDST is an accurate and reliable method using one plate to detect ESBLs and AmpC BLA of the same time. It is suitable for different levels of hospitals.更多还原