铜绿假单胞菌的分布特点耐药性分析

目的分析3年来我院患者铜绿假单胞菌的耐药特点,为临床合理用药提供依据,并有助于医院感染预防与控制。方法对2010年至2012年我院各类感染患者标本中分离获得的铜绿假单胞菌,采用纸片扩散法（K-B法）检测抗菌药物的敏感性,并用WHONET5．3软件对药敏结果进行统计分析。结果3年分离的铜绿假单胞菌共计369株,其对多黏菌素B无耐药,对亚胺培南、美罗培南、头孢哌酮／舒巴坦、哌拉西彬他唑巴坦和阿米卡星的耐药率较低（6．81％～22．73％）,对其他抗菌药物的耐药率较高（32．47％～73．38％）。结论铜绿假单胞菌对多种抗菌药物均具有较高的耐药性,临床上治疗该菌感染时应根据药敏检测结果选择抗菌药物。     

环丙沙星耐药的铜绿假单胞菌药敏情况分析

目的了解对环丙沙星耐药的铜绿假单胞菌的药敏情况。方法细菌的鉴定及药敏试验,均采用法国生物梅里埃公司的VITEK2微生物鉴定与药敏系统,选择经VITEK2测定耐环丙沙星的铜绿假单胞菌(耐药株)68株及对环丙沙星敏感的铜绿假单胞菌(敏感株)67株,统计分析两者对亚胺培南、阿米卡星、庆大霉素、头孢他啶、哌拉西林和哌拉西林他唑巴坦等几种临床上常用抗生素的药敏情况。结果耐药株对以上6种抗生素的敏感率分别为亚胺培南706%,阿米卡星206%,庆大霉素191%,头孢他啶279%,哌拉西林632%,哌拉西林他唑巴坦721%。而敏感株对6种抗生素的敏感率则分别为925%、328%、687%、657%、881%与896%,明显高于耐药株,经χ2检验,除阿米卡星005相似文献   

广州儿童医院重症监护病房感染病原菌的分布及耐药性分析

目的探讨儿科重症监护病房（PICU）感染病原菌的分布及耐药情况,为临床合理选用抗菌药提供参考。方法对广州市儿童医院PICU病房2003年11月-2005年10月各类感染标本所分离的病原菌的分布及耐药性进行回顾性分析。结果共检出295株病原菌,其中革兰阴性杆菌213株（72．2％）,主要为铜绿假单胞菌、不动杆菌等非发酵菌;革兰阳性球菌58株（19．7％）,主要为葡萄球菌;真菌24株（8．1％）。药敏结果提示铜绿假单胞菌及不动杆菌对亚胺培南、头孢哌酮／舒巴坦、环丙沙星及阿米卡星较为敏感,铜绿假单胞菌对头孢噻肟耐药率较高,而不动杆菌对头孢哌酮、氨曲南、庆大霉素耐药严藿。肠杆菌科细菌对氨苄西林、氨苄西林／舒巴坦、哌拉西林及多种头孢菌素耐药率较高而对亚胺培南、头孢哌酮／舒巴坦、阿米卡星等较敏感。葡萄球菌对青霉素、红霉素严重耐药,但对万古霉素、替考拉宁及阿米卡星敏感性高。结论铜绿假单胞菌等非发酵菌已成为PICU病房感染的主要病原菌。根据病原菌种类及药敏结果合理应用抗菌药是有效控制危重病患儿感染和减少耐药菌株产生的重要手段。     

2010年宜昌市铜绿假单胞菌的耐药性分析

了解宜昌市铜绿假单胞菌（Pseudomonas aeruginosa）临床分离株的耐药现状。宜昌市城区5所医院临床分离的铜绿假单胞菌菌株,用K-B法作药敏试验,并根据统计其耐药情况及耐药表型（模式）分析可能存在的耐药机制。临床分离的铜绿假单胞菌共1 575株,耐药率依次为阿米卡星7.1%、美罗培南17.2%、头孢吡肟20.4%、头孢哌酮/舒巴坦21.0%、哌拉西林/他唑巴坦22.5%、环丙沙星23.1%、庆大霉素23.4%、头孢他啶25.0%、亚胺培南25.2%、哌拉西林30.4%、氨曲南34.5%、复方新诺明59.0%、米诺环素75.6%。多重耐药（MDR）和泛耐药（PDR）株分别占41.5%和0.17%。对各种抗假单胞菌药物分别耐药的菌株仍有13%～25.7%对阿米卡星敏感,提示在严重铜绿假单胞菌感染患者的治疗中,β内酰胺类抗假单胞菌药加氨基糖苷类仍是一个很好的联合用药组合。细菌耐药性仍呈增长趋势,临床上感染多重耐药和泛耐药的铜绿假单胞菌的治疗仍很棘手,应合理使用抗生素,尽量延缓耐药菌株的出现。     

Antibiotic susceptibility and occurrence of ESBL in Pseudomonas aeruginosa strains isolated from different clinical specimens

The aim of this study was to evaluate the drug susceptibility of 132 P. aeruginosa strains isolated from patients hospitalized in SPSK University Hospital in Bialystok. The isolates were obtained from clinical specimens over an 11-month period in 2001 and 2002. All the strains were identified in automatic ATB system using API 20 NE strips, and their susceptibility to antibiotics was tested by standard disc-diffusion method and agar dilution method. The minimal inhibitory concentration (MIC) was determined for five antibiotics: piperacillin, amikacin, ceftazidime, imipenem and ciprofloxacin. The majority of strains were susceptible to ceftazidime (91.7%), piperacillin combined with tazobactam (85.6%), amikacin (80.3%), meropenem and imipenem (81.8%). Many of our strains were resistant to cefotaxime (73.5%), ticarcillin (53%) and ciprofloxacin (48.5%). Also, the trial was undertaken to detect strains producing extended-spectrum beta-lactamases (ESBL) and inducible beta-lactamases (IBL) among P. aeruginosa rods isolated from different specimens. ESBL-producing strains were detected with double disc test (DDST) and combination double disc (CD) test. Clavulanate was applied as the inhibitor of these beta-lactamases. Strains producing ESBL were not found. On the other hand, as many as 127 P. aeruginosa strains (96.2%) produced inducible beta-lactamases (IBL).     

耐喹诺酮类铜绿假单胞菌的耐药性分析及血清学分型

目的了解广州地区喹诺酮类耐药铜绿假单胞菌的耐药性及泵抑制剂对其耐药水平降低的作用,并调查血清型分布情况。方法用法国生物梅里埃公司的微生物鉴定和药敏分析系统VITEK-2对127株铜绿假单胞菌进行鉴定和药敏检测,并采用羰酰氰基-对-氯苯胺(CCCP)与环丙沙星共同作用,以琼脂稀释法测定耐药菌的最低抑菌浓度(M IC)的变化,同时用玻片凝集法对耐药株进行血清学分型。结果环丙沙星耐药菌对哌拉西林/他唑巴坦(65.5%)的敏感率最高,只有阿米卡星(64.4%)、哌拉西林(51.7%)和妥布霉素(50.6%)的敏感率大于50.0%,而敏感菌对美罗培南(97.5%)及左氧氟沙星(97.5%)的敏感率最高,妥布霉素(95.0%)次之,对临床常用的13种抗生素,耐药菌较敏感菌的敏感性明显降低(P值均<0.001);耐药菌受泵抑制CCCP作用,M IC降低1~4个稀释度;血清分型率为93.1%,耐药菌的血清型以B型(20.7%)和L型(19.5%)为主。结论耐喹诺酮类铜绿假单胞菌对临床常用抗生素的敏感性降低,并呈多重耐药,使用抗生素 泵抑制剂可提高药物对铜绿假单胞菌的敏感性;血清学分型可以快速简单地监测铜绿假单胞菌在医院内的流行情况。     

Distinct synergistic action of piperacillin and methylglyoxal against Pseudomonas aeruginosa

The dicarbonyl compound methylglyoxal is a natural constituent of Manuka honey produced from Manuka flowers in New Zealand. It is known to possess both anticancer and antibacterial activity. Such observations prompted to investigate the ability of methylglyoxal as a potent drug against multidrug resistant Pseudomonas aeruginosa. A total of 12 test P. aeruginosa strains isolated from various hospitals were tested for their resistances against many antibiotics, most of which are applied in the treatment of P. aeruginosa infections. Results revealed that the strains were resistant to many drugs at high levels, only piperacillin, carbenicillin, amikacin and ciprofloxacin showed resistances at comparatively lower levels. Following multiple experimentations it was observed that methylglyoxal was also antimicrobic against all the strains at comparable levels. Distinct and statistically significant synergism was observed between methylglyoxal and piperacillin by disc diffusion tests when compared with their individual effects. The fractional inhibitory concentration index of this combination evaluated by checkerboard analysis, was 0.5, which confirmed synergism between the pair. Synergism was also noted when methylglyoxal was combined with carbenicillin and amikacin.     

皮肤软组织感染病原菌分布及耐药性分析

目的 调查皮肤软组织感染病原菌的种类及耐药性,为临床合理使用抗菌药物提供科学依据.方法 利用WHONET 5.6对2009年1月至2011年12月皮肤软组织感染患者脓液或分泌物细菌培养及药敏试验结果进行回顾性分析.结果 共分离菌株444株,金黄色葡萄球菌(SAU)分离率居第1位,171株占38.5％;表皮葡萄球菌居第2位,54株占12.2％;铜绿假单胞菌第3位,43株占9.7％;头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星、亚胺培南和美罗培南对革兰阴性杆菌有较好的抗菌活性(耐药率≤3.3％);金黄色葡萄球菌对青霉素和红霉素的耐药率为93.6％和65.0％,对呋喃妥因、利奈唑胺、利福平、莫西沙星和左旋氧氟沙星耐药率为0％、0％、1.4％、2.2％和9.3％,未检出万古霉素耐药株;耐甲氧西林金黄色葡萄球菌(MRSA)检出率25.7％ (44/171);MRSA和甲氧西林敏感金黄色葡萄球菌(MSSA)对氨苄西林/舒巴坦、利福平、莫西沙星三种药物的敏感性差异有统计学意义.结论 引起皮肤软组织感染病原菌以阳性球菌尤其是金黄色葡萄球菌为主,临床上应尽量根据药敏试验结果选用抗生素,合理用药.     

重症监护病房脑膜脓毒金黄杆菌医院感染的调查分析

目的通过对重症监护病房（Intensive Care Unit,ICU）内脑膜脓毒金黄杆菌（Chryseobacterium meningosepticum）医院感染的临床特征和耐药性调查分析,为临床更好地预防和治疗该细菌所引起的感染提供参考。方法对我院2007年1月至2008年12月重症监护病房脑膜脓毒金黄杆菌医院感染的47例患者进行回顾性调查。结果45例（95．7％）患者均有严重的基础疾病,与感染相关的因素还包括侵入性操作、深静脉置管、环境污染及长期广谱抗菌药物的应用;47株脑膜脓毒金黄杆菌全部检测出金属β-内酰胺酶,具多重耐药性。体外抗菌活性较好的抗菌药物依次为万古霉素（100．0％）、头孢哌酮／舒巴坦（83．0％）、哌拉西林／他唑巴坦（57．1％）、替卡西林／克拉维酸（52．4％）和复方新诺明（45．2％）,其余所检测的抗菌药物体外抗菌活性均在6．4％-0。结论缩短住院时间、加强病区环境和空气监控、尽量减少侵入性操作和合理使用抗生素是减少脑膜脓毒金黄杆菌感染发生的重要措施。治疗脑膜脓毒金黄杆菌,可选用万古霉素、头孢哌酮／舒巴坦、哌拉西林／他唑巴坦、替卡西林／克拉维酸和复方新诺明。     

ICU革兰阴性菌院内感染病原菌及耐药变化

目的探讨ICU革兰阴性菌院内感染的病原菌及抗生素耐药情况,为临床防治提供依据。方法对温州医学院附属第一医院ICU2002年1月-2004年12月院内感染的所有标本分离的革兰阴性菌及耐药性进行回顾性分析。结果革兰阴性菌院内感染的部位主要在下呼吸道,其次为尿路。372株G^-菌中,前5位的分别是鲍曼不动杆菌62株（16．67％）、洋葱假单胞菌61株（16．4％）、铜绿假单胞菌58株（15．59％）、嗜麦芽窄食假单胞菌41株（11．02％）,肺炎克雷伯杆菌34株（9．14％）。3年中,鲍曼不动杆菌和嗜麦芽窄食假单胞菌所致的院内感染有所增加;在细菌耐药性方面,G^-菌的耐药率普遍提高,对头孢哌酮／舒巴坦（13．25％）、哌拉西彬他唑巴坦（23．93％）、头孢他啶（39．66％）、美罗培南（32．17％）、奈替米星（48．36％）的耐药率〈50％,但对亚胺培南高达50．87％。结论ICU院内感染革兰阴性菌对除头孢他啶外的3代头孢耐药率普遍高,对亚胺培南耐药率高,加强细菌耐药性检测,合理使用抗生素很关键。     

泌尿外科住院患者泌尿系感染病原菌分布及其耐药性分析

了解泌尿外科住院患者泌尿系感染病原菌的分布及其对常用抗菌药物的耐药情况。对泌尿外科泌尿系感染住院患者的消毒中段尿培养结果进行回顾性分析,尿培养菌株的鉴定、药敏分析和统计分析采用VITEK2全自动微生物仪。3 a中泌尿外科泌尿系感染住院患者共分离到细菌1 233株,其中革兰阴性杆菌772株,占62.61%,革兰阳性球菌353株,占28.63%,真菌82株,占6.65%。菌株数居前5位的细菌依次为:大肠埃希菌、肠球菌属、洋葱伯克霍尔德菌、假丝酵母菌属和变形杆菌。分离大肠埃希菌产ESBLs率为66.18%,粪肠球菌中未发现VRE菌株,屎肠球菌VRE为0.8%。未发现对美洛培南耐药的大肠埃希菌,对肠埃希菌耐药率在10%以下的有亚胺培南、阿米卡星、哌拉西林/他唑巴坦和呋喃妥因。洋葱伯克霍尔德菌和铜绿假单胞菌对所监测的抗菌药物均有不同程度的耐药。未发现对万古霉素、替考拉宁及氨苄西林耐药的粪肠球菌。泌尿系感染的病原菌以大肠埃希菌和肠球菌为主,非发酵革兰阴性杆菌及假丝酵母菌所占比例超过20%,不容忽视,病原菌的耐药率较高,临床医生应根据尿培养和药敏试验结果合理使用抗菌药物。     

The patterns and transmissibility of antibiotic resistance among clinical strains of Pseudomonas aeruginosa.

Four hundred and ninety-eight predominantly pyocin-type 10 clinical strains of Pseudomonas aeruginosa were analyzed for resistance to carbenicillin, cefoperazone, cefotaxime, ceftazidime, gentamicin, amikacin and netilmicin. Based on NCCLS-recommended MIC breakpoints, 245 strains were found to be resistant, of which 41.6% were resistant to carbenicillin, 38% to gentamicin, 37.8% to netilmicin, 26.3% to cefoperazone, 17.9% to cefotaxime, 0.6% to amikacin and none to ceftazidime. Quadruple resistance to carbenicillin, cefoperazone, gentamicin and netilmicin was the most frequent pattern observed. Resistance to older antibiotics (kanamycin, streptomycin and tetracycline) and to mercuric chloride were also common. Conjugation experiments suggested that self-transmissible and non-transmissible plasmids occurred in at least 66 strains.     

Influence of an extended incubation period on values of minimum inhibitory concentrations of antibiotics in Stenotrophomonas maltophilia clinical strains

In 106 Stenotrophomonas maltophilia clinical strains the susceptibility to 19 kinds of antibiotics was tested by the broth dilution micromethod at 24 h and 48 h incubation. Isolated strains demonstrated the lowest frequency of resistance to cotrimoxazole (7.5% of resistant strains at 24 h incubation and 18.9% at 48 h), ofloxacin (13.2% and 30.2%), ciprofloxacin (19.8% and 50.9%) and to cefoperazone/sulbactam (20.8% and 37.7%). The smallest growth of the number of resistant strains after extended incubation was recorded in gentamicin (by 10.4%), ceftazidime (by 11.3%) and cotrimoxazole (by 11.4%). On the contrary, the largest growth of resistance was demonstrated in cefoperazone and ciprofloxacin (by 31.1%). Average values of the growth of minimum inhibitory concentrations (MICs) were lowest in ciprofloxacin and ofloxacin (2.3 times) and highest in piperacillin/tazobactam (4.5 times) and piperacillin (5.0 times). As far as the stability of MIC is concerned, the largest occurrence of strains with the MIC growth doubled as a maximum was found in ceftazidime (78.4%), ofloxacin (76.1%) and ciprofloxacin (75.3%), the smallest in piperacillin/tazobactam (43.2%) and piperacillin (38.9%). The importance of incubation extended to 48 h during the testing of S. maltophilia strains was noted for correctly setting their susceptibility to antibiotics.     

肾综合征出血热少尿期的肺部感染菌群分布及其耐药分析

目的了解肾综合征出血热少尿期的肺部细菌感染对临床治疗的意义。方法送检的所有痰液标本按常规方法进行细菌分离鉴定,药敏试验为K-B法,ESBLs以双纸片协同试验进行,MRS检测为纸片筛选法。结果痰液标本338份,细菌培养检出率68.9%,革兰阴性菌占优势,以铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌为主。对碳青霉烯类、头孢哌酮/他唑巴坦均分别低于9.09%、12.5%,头孢吡肟为27.4%,其余抗生素的耐药率均高于31.3%。3种主要产ESBLs菌对碳青霉烯类、头孢哌酮/他唑巴坦均分别低于15.8%、17.2%,其余抗生素的耐药率均高于55.2%。革兰阳性菌主要以金黄色萄葡球菌为主。结论肺部感染以革兰阴性菌占优势,碳青霉烯类、头孢哌酮/他唑巴坦是抗感染治疗的首选药物。     

产ESBLs肺炎克雷伯菌AmpC酶的检测及耐药性分析

目的了解深圳市人民医院产ESBLs肺炎克雷伯菌中产AmpC酶的情况及其耐药性。方法收集产ESBLs肺炎克雷伯菌临床株126株,应用Tris-EDTA纸片法检测AmpC酶。用琼脂稀释法测定菌株对11种抗生素的最低抑菌浓度（MIC）。结果126株ESBLs阳性的肺炎克雷伯菌中12株检出AmpC酶,检出率为9.5%。AmpC阳性菌株对头孢西丁、头孢他啶、氨曲南、氨苄西林/舒巴坦和阿莫西林/克拉维酸的耐药率达100%,对阿米卡星和哌拉西林/他唑巴坦的耐药率分别为83.3%和33.3%,其中头孢西丁、头孢他啶、氨曲南、阿莫西林/克拉维酸、阿米卡星和哌拉西林/他唑巴坦的耐药率显著高于AmpC阴性株（P〈0.05）。结论深圳市人民医院产ESBLs肺炎克雷伯菌中检出AmpC酶阳性株,其耐药性强于单产ESBLs菌株。     

下呼吸道感染耐环丙沙星铜绿假单胞菌的分布与耐药性

目的了解耐环丙沙星铜绿假单胞菌的流行情况,分析耐环丙沙星铜绿假单胞菌的耐药性,比较耐环丙沙星铜绿假单胞菌与环丙沙星敏感铜绿假单胞菌的耐药性差异。方法选择贵阳医学院第三附属医院2011年6月至2014年11月下呼吸道感染标本中分离出的231株耐环丙沙星铜绿假单胞菌与环丙沙星敏感铜绿假单胞菌,按照《全国临床检验操作规程》进行微生物病原菌鉴定。采用Kirby-Bauer琼脂扩散法进行药敏试验,结果使用SPSS 17.0软件进行统计分析。结果下呼吸道感染标本中共分离出铜绿假单胞菌231株,其中耐环丙沙星铜绿假单胞菌检出率25.54%。从科室分布看,神经外科分离率最高,占47.46%,其次ICU、呼吸内科与消化内科分别占18.64%、13.56%、10.17%;下呼吸道感染耐环丙沙星铜绿假单胞菌菌株与环丙沙星敏感铜绿假单胞菌菌株对头孢曲松、阿米卡星、亚胺培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦等19种抗菌药物的耐药率分别为95.65%,71.83%;42.86%,7.69%;17.39%,2.70%;33.33%,11.02%;22.22%,8.00%。下呼吸道感染耐环丙沙星铜绿假单胞菌菌株耐药率明显高于环丙沙星敏感铜绿假单胞菌菌株,差异具有统计学意义(P0.05)。结论耐环丙沙星铜绿假单胞菌表现为多重耐药性,给临床治疗带来很大的困难。因此严格掌握抗菌药物的选用是延缓病原菌对抗菌药物耐药的有效方法。     

Antimicrobial sensitivity of Escherichia coli strains with K1 antigen isolated from pregnant women and newborns

The aim of this study was comparison of the susceptibility to antibiotics of E. coli strains with K1 antigen (E. coli K1+) and non-K1 E. coli strains (E. coli K1-). This study included 67 of E. coli K1+ and 67 of E. coli K1- strains isolated in the time period from June to September of 2008 from pregnant women and newborns hospitalized at dr. J. Biziel University Hospital number 2 L. Rydygier Collegium Medicum in Bydgoszcz Nicolaus Copernicus University in Toruń. Antimicrobial susceptibility of E. coli strains was tested by the disc-diffusion method, on the Mueller Hinton 2 Agar (Becton Dickinson). It was found that 64,2% of E. coli K1+ strains and 53,7% of E. coli K1-strains were susceptible to all tested antibiotics and chemioterapeutics. E. coli K1- strains were more often than E. coli K1+ nonsusceptible to at least one antimicrobial agent. The obtained results indicate that E. coli K1+ strains significant differed in the susceptibility to ampicillin/sulbactam (85,1% versus 95,5%) (p=0,041), cephalothin (70,1% versus 85,1%) (p=0,038) and tetracycline (91,0% versus 74,6%) (p=0,012) from E. coli K1-strains. All tested E. coli K1+ and K1-strains were sensitive to piperacillin/tazobactam, cefoperazone/sulbactam, cefotaxime, ceftazidime, cefepime, imipenem, amikacin, netilmicin and tigecycline. There weren't the ESBL-producing strains among tested E. coli K1+ and K1- rods.     

Drug susceptibility of Pseudomonas aeruginosa strains isolated from patients of a hospital and specialistic outpatients clinics of the SP ZOZ in Nidzica

The aim of this study was to evaluate a frequency of isolation and antimicrobial susceptibility testing (AST) of Pseudomonas aeruginosa strains cultured from clinical specimens collected from patients hospitalized in wards and specialistic outpatients clinics of a hospital in Nidzica (01. 09. 2000 -31. 12. 2003). During over three years 392 Pseudomonas aeruginosa strains were cultured from 16346 clinical samples provided to bacteriological laboratory. P. aeruginosa strains were isolated from 2.5% of examined specimens. Susceptibility of Pseudomonas aeruginosa strains to antimicrobial agents was tested. The highest in vitro activity against clinical P. aeruginosa strains demonstrated imipenem. One strain was resistant to imipenem. This strain was isolated from a patient of a surgical department. Metalo-beta-lactamase was not detected (MBL-negative strain).Twenty nine strains were ESBL producer (7.4% of all strains). The contribution of Pseudomonas aeruginosa strains to the etiology of nosoconial and ambulatory infections increases. In vitro activity of antibacterial agents against P. aeruginosa strains should be monitored during therapy of infections. Resistance to antibiotics/chemothe-rapeutics may be acquired during treatment with antibacterial agent to which P. aeruginosa strain was susceptible according to the antibiogram.     

Antibiotics sensitivity and characteristics of the esculin-positive Pseudomonas aeruginosa biovar]

Strains of Pseudomonas aeruginosa hydrolyzing esculin were isolated for the first time. They amount to 17.1 +/- 2.0% (60 from 325) of the investigated P. aeruginosa strains isolated from the clinical material in St. Petersburg. Esculin hydrolysis was measured by micromethod in plates, results were analysed after 3-hours incubation at 37 degrees C. Esculin-positive strains possesed biovar properties: they are widely spread, demonstrated other characteristic features (absence of triethylamine odour, specific colonies lysis), are stable on ability to hydrolyse esculin while culture storage and after repeated culturing. Typical strain of esculinolytica biovar was deposited into the culture collection of the National Research Institute of Agricultural Microbiology as P. aeruginosa ARRIAM 64-A. Susceptibility testing of the esculin-positive strains by disk-diffusion method revealed that most strains were inhibited by imipenem (86.6%), amikacin (75.0%), ceftazidime (65.0%), meropenem (60.0%), aztreonam (51.6%). The percent of strains susceptible to other antibiotics was lower: azlocillin--33.3%, netilmycin--33.3%, piperacillin--26.6%, ceftriaxon--18.3%. Only small number of strains were inhibited by ciprofloxacin (8.3%), gentamycin (3.4%), cefoperazone (1.7%) and carbenicillin (1.7%). The results may be used for empiric therapy before the isolated strain susceptibility is tested but only according to positive esculin-hydrolysis express-test evaluated in 3-hours period.     

不同时期肠杆菌科细菌产ESBLS及耐药性的监测

目的对不同时期肠杆菌科细菌产超广谱β-内酰胺酶（ESBLS）及耐药性进行监测。方法采用生物梅里埃ATB药敏试验板测定肠杆菌科细菌中大肠埃希菌和肺炎克雷伯菌对抗生素的敏感性,同时用表型确证法检测ESBLS。结果肠杆菌科细菌2006-2008年与2009-2011年两个时期相比,ESBLS的检出率增长近50%。对亚胺配南、头孢吡肟、头孢西丁耐药率较低,对哌拉西林/他唑巴坦、阿米卡星的耐药率次之,对其他β-内酰胺类、氨基糖苷类、喹诺酮类及磺胺类抗生素的耐药率较高,且两个时期相比耐药率增加明显,差异具有统计学意义（P〈0.05）。结论临床产ESBLS菌株不断增多,多重耐药现象越来越严重,临床实验室应当把ESBLS的检测作为常规监测工作,有效指导临床选用抗菌药物。