| Antibiotic application generally is not only to spell convenience about treating diseases for human ,but also to produce drug resistance for bacterium .Generous application of third generation cephalosporin especially induce to appear drug resistance strains of producing extended- spectrumβ-lactamase.production of extended -spectrumβ-lactamases was induced by application of the third generation cephalosporin. extended -spectrumβ-lactamases was encoded by plasmid ,which sacrifice drug resistance genes to diffuse among germs through patterns of conjugation,transformation and transduction ,sacrifice sensitive bacteria to change drug resistance bacteria.bacterium of producing extended-spectrumβ-lactamases have drug resistance spectra widely,display multidrug resistance, these cause to threaten enormously for clinical treatment. extended -spectrumβ-lactamases was one of main mechanism of enterobacteriaceae bacterium drug resistance. Proportions of bacterium coli and klebsiella pneumoniae about producing extended -spectrumβ-lactamases strains are tallest in enterobacteriaceae bacterium .Enterobacteriaceae bacterium were indentified from clinical infection bacterium of the third affiliated hospital of jilin university and affiliated hospital of changchun medical university,then undertake drug sensitivity test for them with choosing dodeca species antibiotics,finally choose enterobacteriaceae bacterium of drug resistance about cephalosporins and penicillin to perform detection of extended -spectrumβ-lactamases .Drug resistance conditions of Bacterium were understood through drug sensitivity test and detection conditions of extended-spectrumβ-lactamases,which sacrifice clinical medication to aim directly at some kind of antibiotic.Not only can this achieve therapeutic efficacy,but also decrease production of bacterial drug resistance .Objective Analyzing antibiotic condition in clinical examples and detection condition of extended-spectrumβ-lactamase by identification and isolation of bacteriascites in clinical infection ,drug sesensitivity test and detection of extended-spectrumβ-lactamase.So that profit to direct clinical medication.Method First bacterium were isolated culture with agar streaking,Then Gram-Negative bacillus were identified with Gram staining ,subsequently oxidation enzyme negative germs were separated with oxidation enzyme agent,finally germs were identified with Enterobacteriaceae germ biochemistry and coding volumn. Drug sesensitivity test was operated with flate plate double dilution method . extended-spectrumβ-lactamase was detected with slip diffusion method .Result 87 strains bacterium coli are 53.4% of totle count in 163 strains Enterobacteriaceae bacterium of isolation and identification .41 strains Klebsiella pneumoniae are 25.2% of sum. 21 strains serratia are 12.9% of totle.14 strains bacteria levans are 8.5% of grand totle.Drug resistance rate of benzylpenicillin sodium,,ampicillin sodium,cefradine,ceftriaxone,cefoperazone,cefotaxime,hydrochloric acid spectinomycin,gentamicin sulfate,erythromycin lactobionate,azithromycin,ofloxacin and lactic acid ciprofloxacin is 62.1%,72.4 %,57.5%,34.5%,59.8%,46.0%,36.8%,41.4%,57.5%,49.4%,63.9 %,49.4% in bacterium coli. Drug resistance rate of benzylpenicillin sodium,,ampicillin sodium,cefradine,ceftriaxone,cefoperazone,cefotaxime,hydrochloric acid spectinomycin,gentamicin sulfate,erythromycin lactobionate,azithromycin,ofloxacin and lactic acid ciprofloxacin is 51.2%,80.5 %,48.8%,26.8%,58.5%,58.8%,29.3%,31.7%,46.3%,41.5%,53.7 %,39.0% in Klebsiella pneumoniae. Drug resistance rate of benzylpenicillin sodium,,ampicillin sodium,cefradine,ceftriaxone,cefoperazone,cefotaxime,hydrochloric acid spectinomycin,gentamicin sulfate,erythromycin lactobionate,azithromycin,ofloxacin and lactic acid ciprofloxacin is 67.1%,75.4%,55.1%,40.5%,49.8%,40.2%,28.6%,34.9%,40.1%,38.1%,56.0 %,43.5% in serratia . Drug resistance rate of benzylpenicillin sodium,,ampicillin sodium,cefradine,ceftriaxone,cefoperazone,cefotaxime,hydrochloric acid spectinomycin,gentamicin sulfate,erythromycin lactobionate,azithromycin,ofloxacin and lactic acid ciprofloxacin is 53.5%,79.6%,50.2%,48.1%,47.6%,49.5%,35.7%,46.2%,47.9%,42.9%,34.7 %,31.6% in bacteria levans .MIC50 value of bacterium coli to benzylpenicillin sodium,ampicillin sodium ,cefradine ,ceftriaxone ,cefoperazone , cefotaxime ,hydrochloric acid spectinomycin,gentamicin sulfate, rythromycin lactobionate,azithromycin ,ofloxacin and lactic acid ciprofloxacin is128,128,32,8,2,1,4,8,16,16,8,8 ug/ml. MIC90 value is >128,>128,128,64,128,32,64,128,64,128,32,64 ug/ml . MIC50 value of klebsiella pneumoniae to benzylpenicillin sodium,ampicillin sodium ,cefradine ,ceftriaxone , cefoperazone , cefotaxime ,hydrochloricacid spectinomycin, gentamicin sulfate , rythromycin lactobionate, azithromycin ,ofloxacin and lactic acid ciprofloxacin is 64,32,64,4,1,2,8,4,3,2,8,2,1 ug/ml,MIC90 value is >128,>128,128,32,64,32,64,128,128,64,16,16 ug/ml . MIC50 value of serratia to benzylpenicillin sodium,ampicillin sodium, cefradine, ceftriaxone ,cefoperazone , cefotaxime ,hydrochloric acid spectinomycin, gentamicin sulfate,rythromycin lactobionate,azithromycin ,ofloxacin and lactic acid ciprofloxacin is 128,64,32,1,1,0.5,4,2,8,4,1,2 ug/ml,MIC90 value is >128,>128,128,32,16,4,32,16,16,32,16,8 ug/ml . MIC50 value of bacterium levans to benzylpenicillin sodium,ampicillin sodium , cefradine ,ceftriaxone , cefoperazone , cefotaxime ,hydrochloric acid spectinomycin, gentamicin sulfate , rythromycin lactobionate,azithromycin ,ofloxacin and lactic acid ciprofloxacin is64,128,16,8,4,4,1,2,8,4,2,4ug/ml,MIC90 value is >128,>128,64,128,128,64,64,>128,32,64,16,8 ug/ml .detection rate of extended-spectrumβ-lactamase in Klebsiella pneumoniae,bacterium coli,serratia and bacteria levans is 29.7%,20.4%,18.6%,7.7%. Drug resistance rate of bacterium coli of producing extended-spectrumβ-lactamase to benzylpenicillin sodium,ampicillinsodium, cefradine ,ceftriaxone , cefo- perazone , cefotaxime , is 100%,94.4%,88.9%,77.8%,72.2%,83.3%. Drug resistance rate of bacterium coli of negative producing extended-spectrumβ-lactamase to above-mentioned antibiotic is 75.4%,69.6%,60.9%,10.1%,8.7%,13.0%. Drug resistance rate of Klebsiella pneumoniae of producing extended-spectrumβ-lactamase to benzylpenicillin sodium,ampicillin sodium, cefradine ,ceftriaxone ,cefoperazone , cefotaxime is91.7%,75%,83.3%,91.7%,91.7%,100%. Drug resistance rate of Klebsiella pneumoniae of negative producing extended-spectrumβ-lactamase to above-mentioned antibiotic is 69.0%,55.2%,48.3%,3.4%,13.8%,6.9%.Conclusion Isolation rate of bacterium coli is the best high in four species Enterobacteriaceae bacterium, isolation rate of Klebsiella pneumoniae is lower than bacterium coli. drug fast rate of benzylpenicillin sodium,ampicillin sodium and cefradine in four species Enterobacteriaceae bacterium is fairly high . Drug resistance rate of hydrochloric acid spectinomycin,ceftriaxone,cefoperazone and cefotaxime is higher than others. Four species Enterobacteriaceae bacterium are chiasm drug resistance and multidrug resistance to gentamicin sulfate,ofloxacin and lactic acid ciprofloxacin. detection rate of extended-spectrumβ-lactamase in Klebsiella pneumoniae and bacterium coli is better high, detection rate of extended-spectrumβ-lactamase in Klebsiella pneumoniae is higher than bacterium coli.Both are chief bacterium of producing extended-spectrumβ-lactamase.Drug resistance rate of producing extended-spectrumβ-lactamase is higher than negative producing extended-spectrumβ-lactamase. Detection of extended-spectrumβ-lactamase is to have important meaning.It is easy to direct clinical medication. |
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