天津市区10家医院大肠埃希菌下呼吸道感染68例临床及耐药性分析  

Analysis of clinical features and drugs resistance of 68 cases of lower respiratory tract infection caused by Escherichia coli from 10 hospitals in Tianjin

作　　者：赖雁平[1] 张菊英[1] 葛庚芝[1] 司进[1] 

机构地区：[1]天津医科大学第二医院呼吸内科,天津300211

出　　处：《天津医科大学学报》2004年第3期408-410,共3页Journal of Tianjin Medical University

摘　　要：目的 :调查天津市10所医院呼吸科2000年1月～2002年12月收治的大肠埃希菌致下呼吸道感染的临床特点及耐药情况。方法 :对68例大肠埃希菌所致的下呼吸道感染患者的临床表现及细菌培养结果回顾性分析。结果 :呼吸科大肠埃希菌所致的下呼吸道感染中主要为有基础病的社区获得性肺炎、其次为慢性支气管炎急性发作、医院感染。老年人、有慢性基础疾病、长期应用广谱抗生素及使用呼吸机治疗的病人易患大肠埃希菌所致的下呼吸道感染。临床表现为咳嗽62例 (91.2% )、咯痰58例 (85.3 % )、发热45例 (66.2 % ) ,胸部X线异常47例 (69.1 % )表现为多见于下叶的肺斑片、片絮状阴影或肺纹理粗乱。药敏结果显示大肠埃希菌对氨卞西林、阿莫西林/克拉维酸、头孢唑林、头孢呋辛和哌拉西林的耐药率分别达79.3%、72.7 %、68.0 %、58.8%、56.5 % ;而对亚胺培南、头孢哌酮/舒巴坦、阿米卡星和头孢他啶有很好的敏感性。特别是对亚胺培南的敏感率达98.0 %。结论 :大肠埃希菌致下呼吸道感染临床表现不具有特征性 ,主要依据细菌培养和药敏检测结果。亚胺培南、头孢哌酮/舒巴坦。Objective:To investigate the clinical features and drug resistance of lower respiratory tract infecˉtion caused by Escherichia Coli from respiration department of10hospitals in Tianjin during2000～2002.Methods:The clinical data and antibiotic susceptibility studies of68cases were reviewed.Results:In the cases of lower respiratory tract infection caused by Escherichia Coli from respiration department,most cases which had underlying diseases were community-acquired pneumonia,and chronic bronchitis acute attack and nosocomal pulmonary infection were the next.Lower respiratory tract infection caused by Escherichia Coli ocˉcurred mostly in the older patiens,especially accompanied by underlying diseases,long term using of broad spectrum antibiotics and treated by ventilator.Clinical features included cough(62cases91.2%),expectoration(58cases85.3%)and fever(45cases66.2%).Chest X-ray represented lower infiltration in low lobes of lungs and crassitude of lung markings.The antibiotic susceptibility studies showed that the rates of resistance to ampicillin,amoxicillin/clavulanate,cefazolin,cefuroxime and piperacillin were higher,while the rates of susˉceptibility to imipenem,cefoperazone/suobactam,amikacin,and ceftazidime were higher,especiallly the rate of susceptibility to imipenem was the highest(98.0%).Conclusion:Lower respiretory tract infection by Esˉcherichia Coli has no clinical characteristics.The diagnosis and treatment depend on the results of microbial culture and the microbial drug-sensitivity test.Imipenem,cefoperazone/suobactam,amikacin,and cefˉtazidime have been the most efficacious antibiotics in the treatment of lower respiratory tract infection by Esˉcherichia Coli.

关 键 词：下呼吸道感染 大肠埃希菌 耐药性 

分 类 号：R569.12[医药卫生—呼吸系统]