[中国儿科患者中产超广谱β-内酰胺酶大肠杆菌的患病率]

[Prevalence of extended-spectrum beta-lactamase producing Escherichia coli in pediatric patients in China].

作者信息

Wang Li, Yang Yong-hong, Lu Quan, Wang Yi, Chen Yuan, Deng Li, Deng Qiu-lian, Zhang Hong, Wang Chuan-qing, Liu Lan, Xu Xi-wei, Shen Xu-zhuang

机构信息

Microbiology and Immunology Department, Pediatric Research Institute, Beijing Children's Hospital Affiliated to Capital Medical University, Beijing 100045, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2008 May 27;88(20):1372-5.

PMID:18953872

Abstract

OBJECTIVE

To study the drug resistance profiles of extended spectrum beta lactamase (ESBL) producing Escherichia coli (E. coli) and provide guidance for pediatric clinical prescription.

METHODS

5127 strains of ESBL producing E. coli were isolated from 5 children's hospitals in Beijing, Shanghai, Chongqing, and Guangzhou. The minimum inhibitory concentration (MIC) values of 349 strains to 9 antibiotics most in use in pediatrics were measured with agar dilution method.

RESULTS

The prevalent rate of ESBL producing of E. coli was 46.7%. The resistant rates to ampicillin/clavulanic acid, cefotaxime, ceftazidime, and cefepime were 23.1%, 67.2%, 24.5%, and 48.4% respectively, and the intermediate rates were 38.5%, 26.4%, 5.7%, and 19.1% respectively. The resistant rate to amikacin was 5.4%. All the strains were susceptible to imipenem. The MIC90 values of ampicillin, cefotaxime, cefepime, ciprofloxacin, and gentamicin were 256 mg/L or higher. There were differences in the resistance profile to ampicillin/clavulanic acid, cefepime, ciprofloxacin, and gentamicin among different regions.

CONCLUSION

ESBL is extensively prevalent among the E. coli strains isolated from the pediatric clinic that are resistant to most antimicrobial agents except imipenem and amikacin. Regional difference exists in drug resistance to some agents exist.

摘要

目的

研究产超广谱β-内酰胺酶（ESBL）大肠埃希菌（大肠杆菌）的耐药谱，为儿科临床用药提供指导。

方法

从北京、上海、重庆和广州的5家儿童医院分离出5127株产ESBL的大肠杆菌。采用琼脂稀释法测定349株菌对儿科最常用的9种抗生素的最低抑菌浓度（MIC）值。

结果

大肠杆菌产ESBL的流行率为46.7%。对氨苄西林/克拉维酸、头孢噻肟、头孢他啶和头孢吡肟的耐药率分别为23.1%、67.2%、24.5%和48.4%，中介率分别为38.5%、26.4%、5.7%和19.1%。对阿米卡星的耐药率为5.4%。所有菌株对亚胺培南敏感。氨苄西林、头孢噻肟、头孢吡肟、环丙沙星和庆大霉素的MIC90值为256mg/L或更高。不同地区对氨苄西林/克拉维酸、头孢吡肟、环丙沙星和庆大霉素的耐药谱存在差异。