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目的对耐药头孢他啶阴性菌超广谱β－内酰胺酶（ＥＳＢＬｓ）的简便检测方法，并对临床针对性治疗产ＥＳ－ＢＬｓ耐药菌感染提出了建议。方法对我院临床分离的２８株耐头孢他啶阴性菌，采用头孢他啶和头孢他啶／克拉维酸药敏纸条对照方法，进行了超广谱β－内酰胺酶（ＥＳＢＬｓ）检测，比较亚胺培南等１１种抗菌药物对产ＥＳＢＬｓ耐药菌体外抗菌作用。结果产ＥＳＢＬｓ株占全部耐药阴性菌的３９．３％；肺炎克雷伯杆菌并未发现产ＥＳＢＬｓ株存在，大肠埃希氏菌均为产ＥＳＢＬｓ株，铜绿假单胞菌中产ＥＳＢＬｓ株比例为５０％，不动杆菌和阴沟肠杆菌中仅有极少部分产ＥＳＢＬｓ。亚胺培南对产ＥＳＢＬｓ耐药菌表现出最强抗菌作用；产ＥＳＢＬｓ耐药菌对其他第三代头孢菌素存在部分交叉耐药，对两种氟喹喏酮类抗菌药物及庆大霉素交叉耐药较为严重。结论头孢他啶与头孢他啶／克拉维酸药敏纸条对照检测ＥＳＢＬｓ的方法简单实用，值得推广。
Objective To provide a simple and convenient method for detecting extended-spectrum β-lactamase (ESBLs) -resistant ceftazidime-resistant bacteria, and to put forward some suggestions for clinical treatment of ES-BLs-resistant bacterial infections. Methods 28 strains of ceftazidime-resistant bacteria isolated from our hospital were tested for ESBLs using ceftazidime and ceftazidime / clavulanate susceptibility strips. In vitro antibacterial activity of 11 antibacterials against ESBLs producing bacterium. Results ESBLs-producing strains accounted for 39.3% of all drug-resistant bacteria; Klebsiella pneumoniae did not find ESBLs-producing strains exist, Escherichia coli are producing ESBLs strains, Pseudomonas aeruginosa ESBLs producing strains in the ratio 50%, Acinetobacter and Enterobacter cloacae only very few ESBLs. Imipenem showed the strongest antibacterial effect on ESBLs-producing bacterium; ESBLs-producing bacterium had partial cross-resistance to other third-generation cephalosporins. Two kinds of fluoroquinolone antibiotics, Su-cross-resistant more serious. Conclusion The method of detecting ESBLs with ceftazidime and ceftazidime / clavulanic acid susceptibility sensitive strip is simple and practical, which is worth to be popularized.