摘要
目的检测从临床标本中分离的62株奇异变形杆菌对23种抗菌药物的体外活性以及这些杆菌产生超广谱β-内酰胺酶、AmpC酶、金属β-内酰胺酶的情况,正确指导临床合理使用抗生素。方法用API-20E对菌株进行鉴定,双纸片协同试验和确证试验筛选超广谱β-内酰胺酶,纸片扩散法检测AmpC酶,改良Hodge试验检测金属β-内酰胺酶,药敏试验采用标准的纸片扩散法。结果奇异变形杆菌的产酶率为25.8%(16/62),其中超广谱β-内酰胺酶为16.1%(10/62),AmpC酶为9.7%(6/62)、金属β-内酰胺酶为0(0/62)。头孢曲松钠、头孢他啶、头孢匹罗、头孢吡肟、氨曲南、亚胺培南、头孢噻肟钠、丁胺卡那霉素和左氧氟沙星的敏感率大于80%。结论产β-内酰胺酶的奇异变形杆菌在临床中占较大的比例,实验室需加强检测。三代头孢菌素、四代头孢菌素、氨曲南、亚胺培南、丁胺卡那霉素和左氧氟沙星是治疗奇异变形杆菌感染的首选药物。
Objective To determine the activity of 23 antibacterials against 62 strains of Proteus mirabilis isolated from clinical specimens so as to guide the reasonable application of antibiotics. Methods Identification of the strains was performed by the API-20E. Screening of extended-speetrumβ-1actamasesproducing isolates was performed by a double-disk synergy test and a phenotypic confirmatory test,AmpC β-laetamases-producing isolates were determined by the disk diffusion method,metallo-β-lactamases-producing isolates were determined by the modified Hodge test. Antibiotic susceptibilities of Proteus mirabilis isolates was determined by standard disk diffusion. Results The rate of producingβ-1aetamases of Proteus mirabilis was 25.8% （16/62）,extended-spectrumβ-laetamases was 16.1% （10/62）,AmpCl3-1actamases was 9.7 % （6/62）,metallo-β-lactamases was 0（0/62）. The resistant rate of Proteus mirabilis clinical isolates to third-generation cephalosporins, fourth-generation eephalosporins, aztreonam, imipenam, amikacin, levofloxacin,ticacillin/CA was below 20%. Conclusion Clinical laboratories must strengthen to determine Proteus mirabilis of lactamases-producing isolates. Third-generation eephalosporins, fourth-generation eephalospo- rins, azlreonam,imipenem, amikacin, tieacillin/CA and levofloxacin are the first choice for the infections by Proteus mirabilis.
出处
《青岛医药卫生》
2010年第1期7-9,共3页
Qingdao Medical Journal
