产超广谱β-内酰胺酶大肠埃希菌感染及耐药性分析  

Infection status of ESBLs-producing escherichia coli and drug resistance

作　　者：何晓峰[1] 刘金禄[2] 邵端芳[3] 韩旭颖[2] 

机构地区：[1]河北北方学院附属第一医院感染管理处,河北张家口075000 [2]河北北方学院附属第一医院微生物科,河北张家口075000 [3]河北北方学院检验系,河北张家口075000

出　　处：《中华医院感染学杂志》2011年第6期1239-1241,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解医院产超广谱β-内酰胺酶(ESBLs)大肠埃希菌(ECO)的临床分布特点及对常用抗菌药物的耐药性。方法对2008年8月-2010年2月临床分离的287株ECO进行回顾性分析,并按标准化操作规程采用美国BD公司Phoenix100全自动分析系统进行鉴定,药敏分析,产酶检测。结果 103株产EBSLs菌临床科室分离自ICU 37株,占35.9%,呼吸科16株,占15.5%,老年病科12株,占11.7%,儿科15株,占14.6%,血液科13株,占12.6%,其他科室10株,占9.7%;标本尿液中分离出52株,占50.5%,痰液25株,占24.3%,分泌物10株,占9.7%,血液12株,占11.6%,其他4株,占3.9%;产与非产EBSLs ECO对亚胺培南、美罗培南敏感率均为100.0%,产EBSLs ECO对哌拉西林/他唑巴坦、阿米卡星、呋喃妥因敏感率>50.0%,非产EBSLs ECO的敏感率>50.0%的有哌拉西林/他唑巴坦、呋喃妥因、阿米卡星、阿莫西林/克拉维酸、氯霉素、头孢曲松、头孢他啶、头孢吡肟、氨曲南、氨苄西林/舒巴坦。结论产EBSLs ECO临床分布以ICU、呼吸科、老年病科、儿科、血液科较多;感染部位以泌尿道、呼吸道、血液为主;产与非产EBSLs ECO耐药性差异有统计学意义(P<0.05),临床医师应重视药敏结果,严格用药指征,延缓病原菌耐药。OBJECTIVE To investigate the clinical distribution and antibiotic resistance of ECO producing EBSLs and provide the reference for clinical rational application of antibiotics.METHODS The Phoenix 100 automatic microbe analytic instrument was used to identify,analyze the antibiotic resistant rates and detect ESBLs of 287 strains of ECO from all kinds of clinical specimen from Aug 2008 to Feb 2010.RESULTS There were 103 strains of EBSLs-producing ECO,And ICU,respiratory department,old aged Unit,pediatric department and homological department were 35.9%,15.5%,11.7%,14.6% and 12.6%,respectively,the other units was 9.7%.The drug sensitive rate of and non-ESBLs-producing EBSLs-producing ECO to IPM was 100.0% and sensitive to MEM.The sensitive rates to AK,TZP,NM were above 50.0%.However the sensitive rates of Piperacilin/tazobactam FEP,CRO,CTX,SAM,ATM,FOX,PIP and MXF were all above 50.0% in EBSLs-ECO ampicillin/sulbactam.CONCLUSIONS EBSLs-producing ECO mainly distribute in ICU,respiratory department,senile patients unit,pediatric department and homological department.The infection sites are mainly the urinary tract,respiratory tract and blood.The difference of drug resistance between EBSLs-producing ECO and non-EBSLs-producing ECO is statistically significant.The clinicians should attach importance to the drug sensitivity test results,strictly use the antibiotics and prevent the drug resistance of the pathogens.

关 键 词：大肠埃希菌 耐药性 产超广谱Β-内酰胺酶 

分 类 号：R378.21[医药卫生—病原生物学]