肠杆菌科细菌SDD菌株特征及替加环素药敏结果分析

发布时间：2018-11-14 17:40

【摘要】：目的分析医院肠杆菌科细菌剂量依赖性敏感(SDD)菌株的药物敏感性情况和检出分布特征,并检测产超广谱β内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌对替加环素的敏感性,以指导临床对SDD菌株的抗菌药物及对ESBLs产酶株替加环素的选择。方法采用VITEK 2COMPACT全自动微生物分析仪进行细菌鉴定及仪器法抗菌药物敏感性试验。对50株ESBLs阳性大肠埃希菌和50株肺炎克雷伯菌分别采用微量肉汤稀释法、MTS测试条法、Vitek2仪器检测法、纸片扩散法检测替加环素的敏感性。结果采用M100-S24标准头孢吡肟判断为敏感的肠杆菌科细菌有3.58%~12.50%的菌株为SDD菌株;ESBLs阳性大肠埃希菌和肺炎克雷伯菌的SDD菌株检出率分别为13.31%和8.60%,显著高于ESBLs阴性菌株(P0.05);所有肠杆菌科细菌SDD菌株最低抑菌浓度(MIC)4mg/L菌株检出率显著高于SDD菌株MIC 8mg/L菌株检出率(P0.05);ESBLs阳性大肠埃希菌和肺炎克雷伯采用微量肉汤稀释法和MTS测试条法的敏感率均为100%。结论当肠杆菌科细菌头孢吡肟MIC为4mg/L或8mg/L时,实验室应在检验报告提示SDD菌株的检出。替加环素对ESBLs阳性大肠埃希菌和肺炎克雷伯菌的敏感率为100%。
[Abstract]:Objective to analyze the drug sensitivity and distribution of (SDD) strains in a dose-dependent manner, and to detect the susceptibility of extended-spectrum 尾 -lactamase-producing Escherichia coli and Klebsiella pneumoniae to tegacycline. To guide clinical antimicrobials against SDD strains and to select tegacycline from ESBLs producing strains. Methods VITEK 2COMPACT automatic microbiological analyzer was used to identify bacteria and test the antimicrobial susceptibility. Fifty strains of ESBLs positive Escherichia coli and 50 strains of Klebsiella pneumoniae were tested for the sensitivity of tegacyclin by broth dilution method, MTS test strip method, Vitek2 instrument method and disk diffusion method, respectively. Results according to M100-S24 standard cefepime, 3.58% of the strains of Enterobacteriaceae were SDD strains. The positive rates of SDD strains of Escherichia coli and Klebsiella pneumoniae were 13.31% and 8.60%, respectively, which were significantly higher than those of ESBLs negative strains (P0.05). The detection rate of the minimum inhibitory concentration of all Enterobacteriaceae SDD strains (MIC) 4mg/L was significantly higher than that of SDD MIC 8mg/L (P0.05). The sensitivity rates of ESBLs positive Escherichia coli and Klebsiella pneumoniae were 100 by microbroth dilution and MTS test. Conclusion when the cefepime MIC of Enterobacteriaceae is 4mg/L or 8mg/L, the laboratory should indicate the detection of SDD strain in the test report. The susceptibility of tegicycline to ESBLs positive Escherichia coli and Klebsiella pneumoniae was 100%.
【作者单位】：成都军区总医院检验科;
【基金】：四川省卫生厅课题资助项目(130318) 成都军区总医院院管课题资助项目(2013YG-B069)
【分类号】：R446.5

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