临床分离大肠埃希菌的分布及其耐药性分析  

Distribution and resistance analysis of clinical isolated Escherichia coli

作　　者：车惠琴[1] 谭少华[1] 秦美芸[1] 

机构地区：[1]浙江省湖州市第一人民医院检验科,浙江湖州313000

出　　处：《中国卫生检验杂志》2011年第2期404-406,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的:了解我院大肠埃希菌的临床分布及其对常用抗菌药物的耐药情况,为临床抗菌药物的使用提供依据。方法:采用常规方法进行细菌分离及鉴定,运用VITEK-2全自动细菌分析仪进行细菌的鉴定及药敏分析,采用美国临床实验室标准化委员会推荐的纸片扩散确证法检测ESBLs。结果:338株大肠埃希菌中产ESBLs菌共199株,占58.9%,尿中分离151株,产ESBLs菌84株,痰中分离103株,产ESBLs菌82株,产与非产ESBLs菌株间耐药性具有较大差异,不同来源的菌株对不同的抗菌药物耐药性也表现不同,体外药敏试验结果显示:亚胺培南、头孢替坦、丁胺卡那、哌拉西林/他唑巴坦、呋喃妥因、对产ESBLs大肠埃希菌有较好的抗菌活性。结论:医院产ESBLs大肠埃希菌耐药性较严重(58.9%),医院应加强抗菌药物使用的管理,提高抗菌药物的合理使用,降低细菌耐药率的产生。Objective：To investigate the distribution and resistance characteristic of Escherichia coli-in order to provide reference for the chinical application of drugs in our hospital.Methods： All clinical specimens isolated and cultured from patients were identified by using the automatic microorganism analyzer VITEK-2 as well as bacteria′s drug susceptibility tests were performed using counterparts panel.ESBLs were detected by the method recommended by National Committee for Clinical Laboratory Standards（NCCLS）.Results： Of 338 strains of Escherichia coli 199 strains were ESBLs-producing Escherichia coli,The positive rate was 58.9%,From them 151 strains Escherichia coli were isolated in urine and 84 strains were ESBLs-producing,103 strains Escherichia coli were isolated in sputum and 82 strains were ESBLs-producing.The drug resistance difference was obvious between them as well as between strains isolated from different sites.The antibiotic susceptibility tests in vitro showed that imipenem、cefotetan、amikacin piperacillin/tazobactam and nitrofurantoin were effective to ESBLs-producing Escherichia coli.Conclusion： The drug–resistance of ESBLs-producing Escherichia coli is severe（58.9%） so that hospital administers should strengthen antibiotics usage management and improve antibiotics rational usage,inorder to decrease occurrance of bacterial resistance.

关 键 词：大肠埃希菌 超广谱Β-内酰胺酶 耐药性 抗菌药物 

分 类 号：R378.21[医药卫生—病原生物学]