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目的:分析探讨尿路感染大肠埃希菌的耐药性及产头孢菌素酶(AmpC酶)和超广谱β-内酰胺酶(ESBLs)的情况。方法:采用纸片扩散确证法检测ESBLs,酶提取物三维试验法检测AmpC酶。并检测60株大肠埃希菌对18种抗菌药的耐药率。结果:60株大肠埃希菌中检出产酶菌株38株(63.3%),其中单产ESBLs 27株(45.0%),单产AmpC酶8株(13.3%),同时产AmpC酶和ESBLs 3株(5.0%)。大肠埃希菌产酶菌株对18种抗菌药的耐药率均高于平均水平(除亚胺培南)。结论:我院尿路感染中段尿标本中分离的大肠埃希菌对抗菌药耐药的主要原因是产生AmpC酶和ESBLs,对产酶菌株重症感染临床经验用药首选碳青霉烯类抗生素。
Objective: To investigate the drug resistance of Escherichia coli in urinary tract infection and the situation of producing cephalosporin (AmpC) and extended-spectrum β-lactamases (ESBLs). Methods: ESBLs were detected by disk diffusion test and AmpC enzyme was detected by three-dimensional enzymatic extraction. The resistance rates of 60 Escherichia coli to 18 antibacterials were tested. RESULTS: Thirty-eight isolates (63.3%) of ESBLs producing strains were detected in ESBLs isolates, including 27 ESBLs producing strains (45.0%), 8 producing AmpC enzymes (13.3%), 3 AmpC isolates and 3 ESBLs producing strains 5.0%). The resistance rate of Escherichia coli producing strains to 18 kinds of antibacterials were higher than the average (except imipenem). Conclusion: Escherichia coli isolated from urinary samples of urinary tract infection in our hospital is mainly caused by AmpC and ESBLs, and carbapenem is the first choice of clinical experience in severe infections of producing strains.