新乡地区13年儿童与成人大肠埃希菌的耐药性动态监测及对比分析  

DRUG RESISTANCE DYNAMIC SURVEILLANCE AND CONTRAST ON ESCHERICHIA COLI BETWEEN CHILDREN AND ADULTS FOR 13 YEARS IN XINXIANG AREA

作　　者：张敏[1] 王淑娟[1] 王华[1] 申明凤[1] 

机构地区：[1]河南省新乡市第一人民医院检验科,新乡453000

出　　处：《现代预防医学》2012年第2期408-413,共6页Modern Preventive Medicine

摘　　要：[目的]对新乡地区1997～2009年13年间临床分离的儿童和成人大肠埃希菌的耐药情况进行动态监测,了解其对临床常用抗菌药物的耐药状况并进行对比分析。[方法]对13年间临床分离的大肠埃希菌标本成人4037株和儿童685株,用28种抗菌药物进行药敏试验。[结果]对儿童组和成人组大肠埃希菌高度敏感的抗菌药物为亚胺培南,美罗培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、多粘菌素等,对头胞他啶,阿米卡星、头孢吡肟耐药率较低。对其他抗菌药物尤其氨苄西林耐药率较高。成人组耐药率普遍高于儿童组,如头孢呋辛、头孢曲松及头孢吡肟、青霉素、复方新诺明、奈替米星、大部分喹诺酮类药物以及四环素等,均有统计学差异。13年来,除氯霉素耐药率下降差异显著外,大部分抗菌药物的耐药率有普遍增长趋势,且大多有统计学差异。近几年,氨苄西林、亚胺培南、左氧氟沙星耐药率下降,且有统计学差异。产超广谱β-内酰胺酶率分别为儿童组46.3%,成人组49.6%。[结论]针对儿童和成人大肠埃希菌的耐药性动态监测及变迁的区别,为提高抗菌治疗效果,对于成人的耐药率不适用于儿童,各地区应分别定期动态监测成人和儿童的耐药结果以供临床合理选用抗菌药物。[Objective]To dynamically monitor the drug resistance of Escherichia coli identified from clinic between children and adults in Xinxiang area for 13 years（1997-2009）,and understand the drug resistance to clinical routine antibacterial medicines and contrast them.[Methods]We did sensitivity experiments by 28 antibacterial medicines to Escherichia coli（4037 from adults and 685 from children）identified from clinic during 13 years.[Results]The antibacterial medicines of high sensitivity to Escherichia coli were imipenem,moropenem,piperacillin/tazobactam,cefoperazonc/sulfbactalm and polymyxin B etc for children team and adults team.The antibacterial medicines of low sensitivity were ceftazidme,amikacin and cefepime.For other antibacterial medicines,especially amicillin,the resistance rate was higher.The resistance rates of adults team were universally higher than its of children team,such as cefuroxime,ceftriaxone and cefepime,peniciline,trimethoprim/sulfamethoxazole,netilmicn,the most 4-quinolones medicines and tetracycline etc.The differences were all significant mostly.Except choramphenicol had the significant decent,the resistance rates of antibacterial medicines almost had the hoist trend in 13 years.The difference was significant mostly.In recent three years,the resistance rates of some antibacterial medicines,such as amicillin,imipenem and levefloxacin had the fall trend,and the differences were significant.The prduced ESBLs rates were 46.3% of children team and 49.6% of adults team separately.[Conclusion]Aim at the dynamic surveillance the drug resistance and difference of diversity between the children team and the adults team,the resistance rates to adults were not applied to children in order to improve the antibacterial medicines＇ treat effect.The resistance results of adults and children should be dynamic monitored periodically separately for clinical doctor to reasonable use antibacterial medicines in different area.

关 键 词：大肠埃希菌 儿童 成人 动态监测 对比 抗菌药物 

分 类 号：R378.21[医药卫生—病原生物学]