Objective: To investigate isolation and resistance of extended - spectrum β - lactamases ( ESBIs) and Amp C enzymes - producing strains in lower respiratory tracts from respiratory department in our hospital and direct clinician to use antibiotics rationally. Methods: Collected Enterobacter isolated from specimens of lower respiratory tracts of patiens in respiratory department in our hospital, from Jan. 2000 to Jan. 2002, and resistance of the bacteria were tested by using standard Kirby - Bauer method. ESBLs and Amp C enzymes were detected by 3 - D test method. Results: 201 strains of bacteria were isolated, ESBLs -producing strains were 32 (16.0%)and Amp C enzymes - producing strains were 19 (9.5%), and the resistant rate of these two species are higher than that of no enzymes - producing ones. Conclusions: Isolation rate of Klebsiella pneumoniae are the highest among the organisms,E. cloacae are the second. Imipenem, cephamycines and β - 1 actamases inhibitor are effective on ESBLs - producing strains, Amp C enzymes - producing strains are sensitive to imipenem and cefepime, while multiple resistance to aminoglyco -side, quinolone and SD are increased markedly.%目的了解我院呼吸内科病区下呼吸道标本中产超广谱β-内酰胺酶(ESBLs)、AmpC酶细菌检出及耐药情况,以指导临床医生合理使用抗生素.方法收集我院呼吸病房2000年1月～2002年1月期间,下呼吸道标本中分离出的肠杆茵科的细茵,用纸片扩散法检测细茵的耐药性,三维试验的方法检测ESBLs及AmpC酶.结果共分离201株肠杆茵科的细茵,产ESBLs细茵32株,占16%,产AmpC酶细茵19株,占9.5%,药敏结果显示产ESBLs及AmpC酶细茵对11种抗菌素的耐药率均高于非产ESBLs及AmpC细茵.结论呼吸病区下呼吸道标本小肺炎克雷伯杆茵ESBLs检出率最高,达13%,阴沟肠杆菌AmpC酶的检出率较高.亚胺培南头霉素以及酶抑制剂是对产ESBLs细菌较为有效的药物,对产AsmpC酶的细菌,亚胺培南、头孢吡肟效果较好,对于氨基糖苷、喹诺酮、磺胺类抗茵素多重耐药呈上升趋势.
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