【摘要】 目的了解瑞金医院产ESBLs菌株的发生率,初筛试验与确证试验的符合率以及ESBL菌株的耐药情况。方法按照NCCLS标准用纸片扩散法进行初筛实验和确证实验,用Whonet5软件处理实验数据。结果初筛阳性为55株,用确证试验证实其中52株为产ESBLs菌株,2株肺炎克雷伯氏菌同时产AmpC酶,不能用确证实验检测到,可通过阿莫西林/克拉维酸与头孢吡肟的协同现象予以检测。产ESBLs菌株的发生率:大肠埃希氏菌33株(25.4%),肺炎克雷伯氏菌21株(28.5%)。结论本院流行的产ESBLs菌对头孢噻肟的水解能力很强,部分产ESBLs菌株对头孢吡肟和头孢他啶不敏感。ESBLs产生菌对阿米卡星、庆大霉素和环丙沙星有很高的耐药率,分别为37.0%、68.5%和64.8%,亚胺培南和美罗培南对ESBL产生菌的敏感率为100%。更多还原

【Abstract】 Objective To investigate the incidence rate of ESBLs-producin g stains in Ruijin Hospital, the consistency rate between the initial screening test and confirmatory test and it’s resistance to antimicrobial agents. Methods The disc diffusion test according to NCCLS Screening and Conformatory Test fo r ESBLs in Klebsiella pneumonia and Escherichia coli were used.All the data was dealed with Whonet 5 software.Result 55 strains met the standard requirements of the initial screening test.The confirmatory test indicated that 52 strains w ere positive.Another two K.pneumoniae strains can not be detected by this method but were confirmed by the synergistic effect between cefepime and clavulanate a cid.The later experiment proved that these two strains produced AmpC enzyme as w ell.Conclusion ESBLs isolated in our hospital have higher activity to hydroliz e cefetoxime,some ESBLs-producing strains shows resistant to cefepime and ceft azidime.The susceptibility test in vitro showed that ESBLs-producing strains h ave high resistance rate to amikicin,gentamicin,ciprofloxacin, while the resista nce rate to these three agents was 37.0% ,68.5% , and 64.8% separately.Carbe npenems such as impenem and meropemam are stable against ESBLs,the sensitive rat e was 100% .更多还原