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对诱导型β-内酰胺酶及超广谱β-内酰胺酶 (ESBL )试验影响因素进行探讨 ,旨在提高两酶的阳性检出率。方法 :采用纸片相邻法 ,诱导酶测定以亚胺培南为诱导剂放平皿中央 ,周围以头孢他啶、头孢曲松等靶药物纸片与之相邻。 ESBL测定以复方阿莫西林放平皿中央 ,周围以头孢他啶、头孢曲松为底物与之相邻。结果 :诱导酶测定诱导剂与靶药物之间距离以 1 5mm为宜 ,靶药物以两种以上为佳 ,可以起到互补作用 ,并可提高其阳性率。ESBL测定复方阿莫西林和头孢曲松 (或头孢他啶 )之间的距离以 1 5mm为最佳 ,底物亦可选择两种以上三代头孢菌素 ,以提高 ESBL的阳性检出率。结论 :诱导酶和 ESBL测定可以弥补体外常规药敏试验之不足 ,对临床用药有重要的指导作用。
The influencing factors of inducible β-lactamase and ESBL test were discussed in order to improve the positive detection rate of the two enzymes. Methods: The paper adjacent method, induced enzyme assay imipenem as the inducer placed in the center of the plate, surrounded by ceftazidime, ceftriaxone and other target drugs adjacent to the paper. ESBL determination to compound amoxicillin petri dish Central, around to ceftazidime, ceftriaxone as a substrate with the adjacent. Results: The distance between inducer and target drug was 1 5mm, target drug was more than two, which could play a complementary role and increase the positive rate. ESBL determination of compound amoxicillin and ceftriaxone (or ceftazidime) the distance between the best 1 5mm, the substrate can also choose more than three generations of cephalosporins to improve the positive detection rate of ESBL. Conclusion: The determination of induced enzyme and ESBL can make up for the lack of routine drug susceptibility testing in vitro, which has an important guiding role in clinical medication.