大肠埃希菌临床感染分布特征及耐药性分析  

Analysis for distribution and drug resistance of Escherichia coli

作　　者：曹弟勇[1] 徐彬[1] 陈大斌[1] 

机构地区：[1]川北医学院药物研究所,四川南充637007

出　　处：《检验医学与临床》2010年第2期98-100,共3页Laboratory Medicine and Clinic

基　　金：四川省教育厅青年基金资助项目(08zb072)

摘　　要：目的了解川北地区大肠埃希菌的临床分布特征及耐药情况。方法收集临床分离的大肠埃希菌180株,用双纸片表型确证试验检测产超广谱β-内酰胺酶(ESBLs)菌株,琼脂稀释法进行药物敏感试验,敏感、中介、耐药及ESBLs阳性菌株的判定采用美国临床实验室标准化协会(CSLI)2006年公布的标准。结果在180株大肠埃希菌中,来自尿液、痰液、伤口分泌物和急诊病房标本的比率较高。180株大肠埃希菌对氨苄西林、环丙沙星、左氧氟沙星、庆大霉素、复方新诺明、头孢唑林、妥布霉素、氨苄西林/舒巴坦、头孢曲松的耐药率高达32.9%～92.3%。ESBLs阳性大肠埃希菌对氨苄西林/舒巴坦、头孢唑林、头孢曲松的耐药率显著高于ESBLs阴性菌株,ES-BLs阳性大肠埃希菌除增强了对β-内酰胺类抗菌药物耐药外,还表现出对喹诺酮类药物环丙沙星、左氧氟沙星以及氨基糖苷类抗菌药物庆大霉素更高的耐药率。结论川北地区大肠埃希菌主要分布在急诊病房以及尿液、痰液、伤口分泌物标本中,且对临床常用抗菌药物耐药突出,提示临床医生必须加强对该菌感染治疗的合理用药。Objective To investigate the distribution and drug resistance of Escherichia coli in North Sichuan area. Methods 180 strains of Escherichia coli were collected from the the Affiliated Hospital of North Sichuan Medi cal College. The strains of ESBLs were detected by double paper phenotype corroborate test and the drug-susceptibility was evaluated by agar dilution method. The results were assessed with CSLL. Results Escherichia colt was espe cially common in emergency ward and the specimens of urine,sputum and secretion of wound. The resistant rates of 180 strains of Escherichia colt were 32. 9%--92. 3% to ampicillin, ciprofloxacin,levofloxacin,genlamycin,trimethoprim sulfamethoxazole, ecfazolin, tobramicin, ampicillin/ sulbactam, ceftriaxone. The resistant rates of ESBLs positive Escherichia colt were significantly bigher than those of the strains of ESBI.s negative to ampicillin/sulbactam cefazolin,ceftriaxone. ESBLs positive Escherichia colt besides strengthening the beta-lactamase antibiotics resistance. still displayed higher resistance to ciprofloxacin,stereospecific and gentamycin. Conclusion Escherichia colt is mainly distributed in the emergency ward and the specimens of urine, sputum, wound secretion,and its resistance is prominent to clinical used antimicrobials in North Sichuan area. Clinical doctors should pay attention to reasonable selecting antibacterial agents in treating Eschcrichia colt infection.

关 键 词：大肠埃希菌 Β内酰胺酶类 抗药性 细菌 大肠杆菌感染 

分 类 号：R378.21[医药卫生—病原生物学] R516.105.3[医药卫生—基础医学]