产超广谱β-内酰胺酶肠杆菌科细菌的临床分布与耐药性分析

发布时间：2018-06-16 11:38

本文选题：恶性肿瘤 + 大肠埃希菌　；参考：《中华医院感染学杂志》2016年01期

【摘要】：目的分析产超广谱β-内酰胺酶(ESBLs)大肠埃希菌与肺炎克雷伯菌的临床分布及耐药性,以指导临床医师合理选择抗菌药物。方法从2013年1-12月恶性肿瘤住院患者的送检各类标本中分离病原菌,采用法国生物梅里埃公司提供的试剂盒进行菌株鉴定,采用K-B法进行药敏试验,用WHONET5.4软件进行统计分析。结果 2013年1-12月临床感染类标本分离出大肠埃希菌76株、肺炎克雷伯菌63株,其中检出产ESBLs大肠埃希菌46株、肺炎克雷伯菌18株,检出率分别为60.53%和28.57%,未检出泛耐药产ESBLs大肠埃希菌和肺炎克雷伯菌;产ESBLs大肠埃希菌感染标本分布以引流液为主,占23.91%,产ESBLs肺炎克雷伯菌以痰液为主,占72.22%;产ESBLs大肠埃希菌阳性率科室分布以外科最高,占41.30%,产ESBLs肺炎克雷伯菌以内科最高,占44.44%;产ESBLs大肠埃希菌和肺炎克雷伯菌对碳青霉烯类、哌拉西林/他唑巴坦、阿米卡星的敏感性较高,对其他常用抗菌药物严重耐药。结论产ESBLs大肠埃希菌与肺炎克雷伯菌是恶性肿瘤患者肠杆菌科细菌医院感染的重要菌株,检出率与耐药率呈上升趋势,临床应加强细菌学检查并依照药敏结果合理使用抗菌药物,以控制ESBLs菌株在医院传播及流行。
[Abstract]:Objective to analyze the clinical distribution and drug resistance of Escherichia coli and Klebsiella pneumoniae producing extended-spectrum 尾 -lactamases. Methods the pathogenic bacteria were isolated from all kinds of specimens of malignant tumor inpatients from January to December 2013. The strains were identified by the kit provided by French Bio-Meridier Company. The drug sensitivity test was carried out by K-B method and the statistical analysis was carried out by WHONET5.4 software. Results from January to December 2013, 76 strains of Escherichia coli and 63 strains of Klebsiella pneumoniae were isolated from clinical infection samples. Among them, 46 strains of ESBLs producing Escherichia coli and 18 strains of Klebsiella pneumoniae were detected. The positive rates of ESBLs-producing Escherichia coli and Klebsiella pneumoniae were 60.53% and 28.57%, respectively. The positive rate of ESBLs-producing Escherichia coli was the highest in surgical department (41.30%), the highest in internal medicine (44.44%) in Klebsiella pneumoniae and ESBLs-producing Escherichia coli and Klebsiella pneumoniae against carbapenem, piperacillin / tazobactam, Amikacin is highly sensitive and is severely resistant to other commonly used antimicrobial agents. Conclusion ESBLs-producing Escherichia coli and Klebsiella pneumoniae are important strains of nosocomial infection of Enterobacteriaceae in patients with malignant tumor. In order to control the spread and prevalence of ESBLs in hospital, bacteriological examination should be strengthened and antibiotics should be used rationally according to drug sensitivity results.
【作者单位】：南通市肿瘤医院感染管理科;南通市肿瘤医院肿瘤内科;南通市肿瘤医院门诊部;南通市肿瘤医院肿瘤研究所;
【基金】：江苏省卫生厅面上基金资助项目(H200957) 南通市科技计划基金资助项目(HS2012062)
【分类号】：R446.5

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