产超广谱-内酰胺酶和AmpC酶阴沟肠杆菌的表型检测及耐药性分析

目的:监测江汉大学附属医院临床标本中分离出的阴沟肠杆菌产超广谱-内酰胺酶(ESBLs)和AmpC-内酰胺酶的状况及其耐药性,为临床治疗提供依据.方法:用美国临床实验室标准化委员会(NCCLS)推荐的确证实验进行ESBLs的检测,用表型筛选法进行AmpC酶的检测;用纸片扩散法进行药敏试验.结果:从75株阴沟肠杆菌中检出ESBLs阳性9株(12.0%),AmpC酶阳性11株(14.7%);产ESBLs株对亚胺培南、头孢吡肟、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、丁胺卡那等药物的耐药率较低,产AmpC酶株对亚胺培南、头孢吡肟、丁胺卡那等药物的耐药率较低.结论:本院分离的阴沟肠杆菌产ESBLs和AmpC酶情况尚好;临床治疗应在药敏试验的基础上,针对不同的产酶株,选用亚胺培南、头孢吡肟和丁胺卡那等药物.

Phenotype Detection and Drug Resistant Analysis of Enterbacter Cloacae Producing ESBLs and AmpC

Objective: To evaluate the status of Enterbacter cloacae producing ESBLs and AmpC from clinical specimens and analyze the antibiotic susceptibility test results for better treatment.Methods: ESBLs was detected by using the confirmation method according to the NCCLS;AmpC enzyme was detected by using the phenotype screening test;The antibiotic susceptibility test was by Kirby-Bauer method.Results: 9 ESBLs-producing strains were detected in 75 strains(12.0%).The results ofphenotype screening showed 11 strains(14.7%) produced AmpC enzymes.The resistance rate of imipenem,cefepime,piperacillin/tazobatam,cefoperazone/sulbactan,amikacin was lower for ESBLs-producing strain.The resistance rate of imipenem,cefepime,amikacin was lower for AmpC-producing strain.Conclusion: The prevalence of producing ESBLs and AmpC waslower in the hospital.On the base of drug sensitive test,such antibioticsas imipenem,cefepime,and amikacin can be used for the treatment of different strains producing ESBLs or AmpC.