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目的研究大肠埃希菌和肺炎克雷伯菌的产酶情况及耐药模式,并对9种抗生素做药敏试验,比较产酶菌与非产酶菌对9种抗生素的耐药率,为临床治疗产酶菌感染提供理论依据。方法应用头孢西丁三相试验检测AmpC酶,采用美国国家临床实验室标准委员会(NCCLS)表型筛选和确认试验检测ESBLs菌株,以K-B琼脂扩散法做药敏试验。结果在110株大肠埃希菌和肺炎克雷伯菌中,6株(5.45%)产AmpC酶,20株(18.2%)产ESBLs,1株(0.90%)同时产AmpC酶和ESBLs。产酶株对亚胺培南、头孢吡肟、阿米卡星耐药率低。结论产AmpC酶和产ESBLs的大肠埃希菌和肺炎克雷伯菌为多重耐药菌株,治疗产2种β内酰胺酶细菌引起的感染亚胺培南为首选,头孢吡肟和阿米卡星可作为选用药物之一。
Objective To study the enzyme-producing conditions and drug-resistance patterns of Escherichia coli and Klebsiella pneumoniae, and to make antibiotic susceptibility test for 9 kinds of antibiotics to compare the resistance rate of 9 kinds of antibiotics produced by enzyme-producing bacteria and non- Clinical treatment of enzyme-producing bacteria provide a theoretical basis for infection. Methods AmpC enzyme was detected by three-phase cefoxitin test. The ESBLs strains were detected by NCCLS phenotype screening and confirmatory test, and K-B agar diffusion method was used to make drug susceptibility test. Results Of the 110 strains of Escherichia coli and Klebsiella pneumoniae, 6 (5.45%) produced AmpC enzyme, 20 (18.2%) produced ESBLs and 1 (0.90%) produced AmpC enzyme and ESBLs simultaneously. Enzyme-producing strains of imipenem, cefepime, amikacin low resistance rate. Conclusions AmpC β-lactamases and ESBL-producing Escherichia coli and Klebsiella pneumoniae are multi-drug resistant strains. Imipenem is the first choice for the treatment of two β-lactamase-producing bacteria, and cefepime and amikacin Star can be used as one of the drugs.