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目的分析呼吸道感染患儿产超广谱β-内酰胺酶(ESBLs)病原菌的耐药情况及基因表型,以便提高治疗效率。方法收集2016年6月-12月104例呼吸道感染患儿痰液标本分离的ESBLS病原菌,检测ESBLS病原菌对常用抗菌药物的耐药情况,并采用PCR技术分析ESBLS病原菌的耐药基因。结果 104份痰液标本共分离出产ESBLs病原菌32株,其中肺炎克雷伯菌14株,大肠埃希菌14株,其他4株;32株产ESBLs细菌对头孢类抗菌药物高度耐药,对头孢唑林、头孢呋辛、头孢曲松的耐药率达100.00%,对β-内酰胺类抗菌药物/酶抑制剂复合物耐药率为21.88%~34.38%,而对碳青霉烯类抗菌药物的耐药率为0;CTX-M-9型菌株检出率最高,检出率为31.25%,其次为TEM型菌株,检出率为25.00%,未检出OXA-10型、CTX-M-2型与CTX-M-8型菌株。结论呼吸道感染患儿产ESBLs细菌具有多药耐药的表型特征,对头孢类抗菌药物高度耐药,对酶抑制剂复合物部分耐药,而对碳青霉烯类抗菌药物高度敏感,临床应根据药敏结果合理用药。
Objective To analyze the drug resistance and gene phenotype of ESBLs in children with respiratory tract infection in order to improve the treatment efficiency. Methods ESBLS pathogens isolated from sputum samples of 104 children with respiratory tract infection were collected from June to December in 2016. The drug resistance of ESBLS pathogens to commonly used antimicrobial agents was tested. The resistance genes of ESBLS pathogens were analyzed by PCR. Results Thirty-two ESBLs pathogens were isolated from 104 sputum samples, including 14 Klebsiella pneumoniae, 14 Escherichia coli and 4 other strains. 32 ESBLs producing bacteria were highly resistant to cephalosporins, The resistance rate of Zoloft, Cefuroxime and Ceftriaxone was 100.00%, and the resistance rate to β-lactam antibacterial / enzyme inhibitor complex was 21.88% -34.38%, while the antibacterial activity against carbapenems The drug-resistant rate was 0; the highest detection rate of CTX-M-9 was detected (31.25%), followed by TEM (25.00%). No CTX- M-2 and CTX-M-8 strains. Conclusion The ESBLs-producing bacteria in children with respiratory tract infection have the phenotypic characteristics of multidrug resistance, are highly resistant to cephalosporins, partially resistant to enzyme inhibitor complex, highly sensitive to carbapenem-based antimicrobials, and clinically Drug susceptibility results should be based on rational use of drugs.