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目的 调查浙江省产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯菌流行情况及其耐药性.方法 收集各地区临床分离的大肠埃希菌和肺炎克雷伯菌共462株,经酶抑制剂增强的肉汤稀释法 筛选出产超广谱β-内酰胺酶细菌,并用浓度梯度法检测其对9种抗生素的耐药性.结果 浙江省大肠埃希菌和肺炎克雷伯菌中超广谱β-内酰胺酶的检出率分别为34%和38.3%.产 超广谱β-内酰胺酶细菌对头孢他啶、头孢噻肟的耐药率分别为42%和38%,对头孢西丁、头 孢吡肟、头孢哌酮-舒巴坦、哌拉西林-他唑巴坦、阿米卡星、环丙沙星的耐药率均高于不 产酶菌株,所有菌株对亚胺培南都敏感.结论 目前产超广谱β-内酰胺酶细菌感染发生率较高,其对除亚胺培南外的多种抗菌药物有一定 的耐药率.

Objective To investigate the epidemiological status of extended-spectrum β-lactamase (ESBL) producing Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoni ae) and the drug resistance profiles of such organisms. Methods A total of 282 clinical isolates of E. coli and 180 of K. pneumoniae were coll ected from different districts of Zhejiang Province. Inhibitor potentiated brot h dilution tests were performed for detecting extended-spectrum β-lactamases . Etests were performed to detect the drug resistance of these strains against nine commonly used antibiotics.Results The prevalence of extended-spectrum β-lactamases in E. coli and K. pneumoni ae was 34.0% and 38.3%, respectively. The average prevalence of extended-spe ctrum β-lactamases in E. coli and K. pneumoniae was 35.7%. The resistance prevalence of extended spectrum β-lactamase producing strains to ceftazidime and cefotaxime was 40% and 26% respectively, so were those to cefepime, cefoxitin , piperacillin-tazobactam, cefoperazone-sulbactam, amikacin and ciprofloxacin . All these strains were sensitive to imipenem. Conclusion The results in this study showed that the prevalence of extended-spectrum β-l actamases was high, while extended-spectrum β-lactamase producing strains wer e resistant to most antimicrobial agents except imipenem.