产酶革兰阴性杆菌致医院感染与耐药特性

目的：了解超广谱β-内酰胺酶(ESBLs)与诱导型β-内酰胺酶革兰阴性杆菌致医院感染的检出率及耐药特点，对产酶与不产酶菌株进行耐药性对比分析，为临床用药提供依据。方法：双纸片试验检测ESBLs与诱导酶，Etest ESBLs试条确定产ESBLs菌株，对临床分离的960株细菌采用K—B法进行药物敏感试验。结果：哌拉西林、头孢培南、亚胺培南、环丙沙星对296株铜绿假单胞菌的抗菌活性较强；肺炎克雷伯菌和大肠埃希菌对亚胺培南100％敏感，对氨基糖苷类、氟喹诺酮类、磺胺类药物，产ESBLs与不产ESBLs菌株之间呈现交叉耐药。结论：常规药敏试验不能完全反映产诱导酶的铜绿假单胞菌耐药特点，Etest ESBLs试条可提高检测ESBLs的阳性率和准确性，产ESBLs革兰阴性杆菌的耐药性高于非产酶菌株，ESBLs菌引起的感染，应用亚胺培南、头霉素类进行治疗。

INFECTION AND DRUG-RESISANC OF ZYMOGENIC GRAM-NEGATIVE BACTERIA

Objective:To implore the detectable rate and drug-resistance of inhospital infection by extended-spectrum beta-lactamases(ESBLs) and induced beta-lacamases gram-negative bacteria,drug-resistance of zymogenous and non-zymoge nous strain was contrasted to provide prooffor clinical administration.Methods:Double-disktest was used to detect ESBLs and indiced enzyme,and Etest(ESBLs paper) to determince ESBLs strain.960 strains recieed drug-sensitive test by Kirby-Bauer test.Results:296 strains of Pseudomonas were resisted strongly to piperacillim ceftazidime imipenem ciprofloxacin;Klebsiella pneumoniae and Escherichia coli has 100 percent of sensitivity to imipenem,ESBLs and non-ESBLs strains have crossed drug-resistance to aminoglycosides quinolones sulfonamides. Conclusions:Routine drug-sensitivity test can not find completely the drug-resistanc of induced zymogenous Pseudemon as aeruginosa,Etest(ESBLs paper)can increase the positive rate and accuarcy of detecting ESBLs. ESBLs gram-negative bacteria has more durg-resistance than non-ESBLs strain.To deal with the ESBLs-prodicing strains,such antibiotics as imipenem,cefoxitin should be used.