标题：产ESBLs酶大肠埃希菌和肺炎克雷伯菌耐药性分析

      作者：黄育敏
    （海南省妇幼保健院检验中心，海南 海口 570206）

      卷次： 2013年24卷6期

      【摘要】 目的 了解下呼吸道感染产ESBLs酶大肠埃希菌及肺炎克雷伯菌的耐药特性，为临床抗菌药物合理
使用提供依据。方法 采用VITEK-32对大肠埃希菌及肺炎克雷伯菌进行菌株鉴定，采用K-B法进行药敏试验及
采用确证试验进行ESBLs测定。结果 我院下呼吸道产ESBLs大肠埃希菌阳性率为27.1%，产ESBLs肺炎克雷
伯菌阳性率为40.5%；这两种菌对亚胺培南和美罗培南显示100%敏感，对头孢西丁、哌拉西林/他唑巴坦、阿米卡
星也有较高的敏感性。对其余的抗菌药物耐药率均较高，相同药物中产ESBLs菌的耐药率均比非产ESBLs的
高。结论 根据我院的药敏结果分析，建议对大肠埃希菌及肺炎克雷伯菌临床经验用药可选用碳青霉烯类抗生素。

      【关键词】 大肠埃希菌；肺炎克雷伯菌；耐药性；ESBLs

      【中图分类号】 R378.2 【文献标识码】 A 【文章编号】 1003—6350（2013）06—0858—02


Drug resistance analysis of Escherichia coli and Klebsiella pneumoniae producing extended spectrum
beta -lactamases.
HUANG Yu-min. Hainan Provincial Maternity and Infant Health Hospital, Haikou 570206, Hainan,
CHINA

【Abstract】 Objective To investigate the drug resistance of Escherichia coli and Klebsiella pneumoniae pro-
ducing extended-spectrum β-lactamases (ESBLs), and then provide bases for clinical control and treatment of ESBLs
bacteria infection. Methods The bacterial identification of E. coli and K. pneumoniae were performed on VITEK-32,
antimicrobial susceptibility was tested by disc diffusion test (K-B method), and ESBLs was detected by confirmatory
test. Results The positive rate of E. coli producing ESBLs was 27.1%, and the positive rate of K. pneumoniae produc-
ing ESBLs was 40.5%, E. coli and K. pneumoniae had 100% susceptible rate to imipenem and meropenem, and they
were susceptible to cefoxitin, piperacillin/tazobactam, amikacin, but to other antimicrobials, the resistance rate of them
were high. To the same antimicrobial, ESBLs positive strains had higher resistance rate than ESBLs negative ESBLs
strains. Conclusion Accord to the result of drug sensitive test, carbapenem antibiotics could be the best choice to
control the infection due to E. coli and K. pneumoniae.

      【Key words】 Escherichia coli; Klebsiella pneumoniae; Drug resistance; Extended-spectrum β-lactamases (ESBLs)