390株大肠埃希氏菌的科室分布及耐药性分析  

Department distribution and drug resistance of 390 strains of Escherichia coli

作　　者：赵崇高[1] 谢顺清[2] 简雪峰[1] 郭天然[1] 

机构地区：[1]河南科技大学第一附属医院检验科,洛阳471003 [2]河南科技大学医学生物教学实验中心

出　　处：《中国实用医刊》2011年第16期54-56,共3页Chinese Journal of Practical Medicine

摘　　要：目的分析河南科技大学第一附属医院大肠埃希氏菌的科室分布及耐药情况，为控制和预防该菌的感染及指导临床用药提供依据。方法分析2009年1月至2009年12月临床患者的标本，采用WHONET5．4软件进行统计分析。结果390株大肠埃希氏菌主要分布在泌尿内科，其次是呼吸内科；产酶率最高的科室是ICU，其次是呼吸内科。大肠埃希氏菌对头孢哌酮／舒巴坦、哌拉西林／他唑巴坦、亚胺培南保持较高的敏感性，对头孢唑啉、氨苄西林、复方新诺明、环丙沙星、庆大霉素的耐药率〉50％；而产超广谱β－内酰胺酶（ESBLs）大肠埃希氏菌菌株除对头孢哌酮／舒巴坦、哌拉西林／他唑巴坦、亚胺培南有较高的敏感性外，对广谱β－内酰胺类抗生素的耐药率均高于非产ESBLs大肠埃希氏菌（P〈0．05），特别是产ESBLs大肠埃希氏菌对头孢噻肟、头孢三嗪的耐药率高达80％，与头孢他啶、曲氨南的耐药率相比差异有统计学意义（P〈0．05）。结论大肠埃希氏菌耐药严重，特别是产ESBLs大肠埃希氏菌耐药非常严重，临床应重视病原菌的检测，根据药敏结果制定最佳治疗方案，并采取有效措施控制产ESBLs大肠埃希氏菌在医院内的定植和播散。Objective To analyze the department distribution and drug resistance of Escherichia coli and provide basis for controlling and preventing the bacteria. Methods Analyzing the clinical speci- mens during the whole year in 2009 and getting their statistical analysis by WHONET 5.4. Results Three hundred and ninety strains of Escherichia coli were collected, the great majority of them were main- ly distributed in department of urlolgy, which was followed by respiratory department. The highest rate of enzyme production was in ICU, which was followed by respiratory department. The survey showed that Escherichia coli maintained higher sensitivity to Cefoperazone/Sulbactam, Piperacillin/Tazobactam and Imipenem. The survey also showed that the rate of Escherichia toll＇ s antibiotic resistance which was re- lated to Cefazolin, Ampicillin Sodium, Compound Sulfamethoxazole, Ciprofloxacin and Gentamicin was more than 50%. Extended spectrum β - lactamases E. coli has not only higher sensitivity to Cefoperazone/Sulbactam, Piperacillin/tazobactam and Imipenem but also higher rate of antibiotic resistance to broad - spectrum β- lactam antibiotics than non - extended spectrum β - lactamase E. coli （ P 〈 0. 05 ）, especially its rate of antibiotic resistance to cefotaxime and ceftriaxone is up to 80% and it has significant difference in antibiotic resistance with Aztreonam（ P 〈 0. 05 ）. Conclusions Escherichia coli has the severe antibiotic resistance, extended spectrum β- lactamases E. coli has especially highest drug resistantance. Therefore, the detection of pathogenic bacteria should be emphasized in clinical practice, and the best therapeutic regimen should be established by drug sensitivity test, meanwhile, some effective measures should be adopted to control the colonization and dissemination of extended spectrum β- lactamases E. coli in hospital.

关 键 词：耐药率 产超广谱Β-内酰胺酶 大肠埃希氏菌 

分 类 号：R446.5[医药卫生—诊断学]