泌尿道大肠埃希菌感染耐药性与产超广谱β-内酰胺酶分析.doc

泌尿道大肠埃希菌感染耐药性与产超广谱β-内酰胺酶分析 【关键词】 大肠埃希菌 【摘要】 目的 了解泌尿道感染大肠埃希菌对常用抗生素的耐药情况和产超广谱β-内酰胺酶（ESBLs）菌株的耐药特征，指导临床合理用药。方法 用VITEK-32、GNI+卡、GNS-120卡进行菌种鉴定、ESBLs检测和药敏试验。结果 引起泌尿道感染的93株大肠埃希菌ESBLs检出率为25.8%；除亚胺培南外，产ESBLs株对其他15种抗生素的耐药率均明显高于非产ESBLs株；所有受试菌对亚胺培南均敏感。结论 泌尿道感染大肠埃希菌的耐药性日益严重，要重视ESBLs的检测，治疗时应根据药敏试验结果选择抗生素。 【关键词】 大肠埃希菌；泌尿道感染；超广谱β-内酰胺酶；耐药性 Detection of extended spectrum β-lactamases producing escherichia coli in urinary tract and drug resistance analyse DENG Jian-kang, GUO Xiao-lan. Department of Clinical Laboratory, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000,China 【Abstract】 Objective To analyze the constituent ratio and drug resistance characteristics of ESBLs producing bacteria-Escherichia coli in urinary tract and provide the reference for the clinical antibiotics usage.Methods Drug susceptibility tests and ESBLs producing strains were detected with Vitek-32 auto microbial evaluation instrument,GNI+, and GNS-120.Results The ratio of ESBLs producing strain among 93 E. coli isolated from the urinary tract infection samples was 25.8%. Except imipenem, the drug resistance rate of ESBLs producing strains was much higher than that of strains no producing ESBLs to 15 types antibiotics, but susceptible to imipenem all.Conclusion Drug resistance of Escherichia coli in urinary tract infection became more and more serious, which suggested clinical treatment should choose the antibiotics according to susceptiblity tests and detection for ESBLs producing strains. 【Key words】 escherichia coli; urinary tract infection; extended spectrum β-lactamases; drug resistance 泌尿道感染在临床上比较常见，而大肠埃希菌是引起泌尿道感染的首要致病菌 ［1］，各地报道的抗生素耐药率也有所不同 ［2］。为了解泌尿道感染中大肠埃希菌ESBLs的产生及耐药情况，给临床提供选择抗菌药物的依据，本文对我院2003年5月～2005年1月从泌尿道标本分离的93株大肠埃希菌进行了ESBLs检测和药敏试验，现报告如下。 1 材料和方法 1．1 仪器试剂 Vitek-32型全自动微生物鉴定和药敏系统、GNI+鉴定卡、GNS-120药敏卡由法国生物梅里埃公司生产；VITEK比色计（V1210）由日本生产；MH琼脂，呋喃妥因和阿米卡星纸片为北京天坛生物股份有限公司产品。 1．2 标本来源 所有标本均为2003年5月～2005年1月我院疑为泌尿道感染的住院和门诊患者的中段尿。 1．3 质控菌株 标准菌株大肠埃希菌（ATCC 25922）、肺炎克雷伯菌（ATCC 700603）由卫生部临床检验中心提供