患儿呼吸道感染产超广谱β-内酰胺酶病原菌的耐药性分析

发布时间：2018-07-22 15:19

【摘要】：目的分析呼吸道感染患儿产超广谱β-内酰胺酶(ESBLs)病原菌的耐药情况及基因表型,以便提高治疗效率。方法收集2016年6月-12月104例呼吸道感染患儿痰液标本分离的ESBLS病原菌,检测ESBLS病原菌对常用抗菌药物的耐药情况,并采用PCR技术分析ESBLS病原菌的耐药基因。结果 104份痰液标本共分离出产ESBLs病原菌32株,其中肺炎克雷伯菌14株,大肠埃希菌14株,其他4株;32株产ESBLs细菌对头孢类抗菌药物高度耐药,对头孢唑林、头孢呋辛、头孢曲松的耐药率达100.00%,对β-内酰胺类抗菌药物/酶抑制剂复合物耐药率为21.88%~34.38%,而对碳青霉烯类抗菌药物的耐药率为0;CTX-M-9型菌株检出率最高,检出率为31.25%,其次为TEM型菌株,检出率为25.00%,未检出OXA-10型、CTX-M-2型与CTX-M-8型菌株。结论呼吸道感染患儿产ESBLs细菌具有多药耐药的表型特征,对头孢类抗菌药物高度耐药,对酶抑制剂复合物部分耐药,而对碳青霉烯类抗菌药物高度敏感,临床应根据药敏结果合理用药。
[Abstract]:Objective to analyze the drug resistance and gene phenotype of extended-spectrum 尾 -lactamases (ESBLs) producing bacteria in children with respiratory tract infection. Methods ESBLs pathogens were collected from 104 sputum samples of children with respiratory tract infection from June to December 2016. The resistance of ESBLs pathogens to common antibiotics was detected and the resistance genes of ESBLs pathogens were analyzed by PCR. Results 32 strains of ESBLs-producing pathogens were isolated from 104 sputum samples, including 14 strains of Klebsiella pneumoniae, 14 strains of Escherichia coli, and 4 strains of ESBLs-producing bacteria were highly resistant to cephalosporal antibiotics, and were highly resistant to cefazolin and cefuroxime. The resistance rate of ceftriaxone was 100.00um, the resistance rate to 尾 -lactam antibiotics / enzyme inhibitor complex was 21.888 ~ 34.38, and the resistance rate to carbapenes was the highest (31.25%), the next was TEM strain, and the resistance rate of ceftriaxone to carbapenem antibiotics was the highest (31.25%), while the resistance rate of ceftriaxone to 尾 -lactam antibiotics / enzyme inhibitor complex was 21.88% and 34.38%, respectively. The positive rate was 25.00. No strains of OXA-10 type CTX-M-2 and CTX-M-8 were detected. Conclusion the ESBLs-producing bacteria in children with respiratory tract infection have the phenotypic characteristics of multidrug resistance, high resistance to cephalosporins, partial resistance to enzyme inhibitor complexes, and high sensitivity to carbapenems. The clinical application should be based on the results of drug sensitivity.
【作者单位】：宁波市妇女儿童医院儿一科;台州市第一人民医院儿科;宁波明州医院儿科;
【分类号】：R725.6

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