Objective To set up a scrip phenotype screen measurement for checking-out the ESBLs and AmpC qickly and intuitively, which secreted by Escherichia coli and Klebsiella pneumonia,and further more chould offer the exact result for the clinical doctor as soon as possible. Methods To survey the resisting drug bacteria by using K-B system and rational distributing of the scrip in the area. Using FOX detection with scrip,detected AmpC with retrospective analysis by means of examing 83 strains Escherichia coli and 50 strains Klebsiella pneumonia, which were resistant to third generations cephalosporins and the FOX Inhibition zone were 18 mm or less. Results Altogether 107 strains Escherichia coli and Klebsiella pneumonia which produce ESBLs and AmpC at the same time were detected. According to the analysis of the result,we find that the Escherichia coli and Klebsiella pneumonia which were resistant to third generations cephalosporin,were all produce AmpC and with 11 mm orless FOX Inhibition zone. The strians which with 12 mm to 14 mm FOX Inhibition zone accompanying with any one of TZP/SCF/CTX/C or multiple Inhibition zone less than 17 mm produced AmpC too. Conclusion The drug resistance of bacteria strians segregated in our laboratory is showing a rising trend. Using our method,the disposition with the scrip of drug which make for joint detection of bacteria strains producted ESBLs and AmpC,is simple and rapid.and cut down the detective time t0 gain time for saving severe infection. So this method could be spreaded and exploited in the clinical laboratory.%目的 建立一种快速、直观地检测大肠埃希菌和肺炎克雷伯菌产ESBLs和AmpC酶菌株的纸片表型检测法,尽快为临床提供准确药敏结果.方法 采用K-B法,对药敏纸片进行合理布局,观察待检菌株耐药表型.采用头孢西丁(FOX)纸片检测法对耐三代头孢菌素且FOX抑菌圈≤18 mm的83株大肠埃希菌和50株肺炎克雷伯菌进行AmpC 酶的检测,并对检测结果进行回顾性分析.结果 共检出107株同时产ESBLs和AmpC酶的大肠埃希菌和肺炎克雷伯菌.回顾性分析发现,对大肠埃希菌和肺炎克雷伯菌,在三代头孢菌素耐药的同时,头孢西丁(FOX)抑菌圈≤11 mm的菌株,均为产AmpC酶株;或12 mm≤FOX抑菌圈≤14 mm,同时伴有TZP,SCF,CTX/C中任意一个或多个的抑菌圈≤17 mm的菌株,亦为产AmpC酶株.结论 该室分离的致病菌株的耐药性呈明显上升趋势;用该室方法对药敏纸片进行布局,有利于对产ESBLs和AmpC酶菌株的联合检测,该法简便、快速,缩短了对产酶株的检测时间,为重症感染患者的抢救争取了时间,可在临床实验室推广应用.
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