近6年产超广谱β内酰胺酶大肠埃希菌的耐药变迁  

Analysis of Antibiotic Resistance to Change of Extended Spectrum β-lactamases Producing Escherichia Coli Isolates Nearly 6 Years

作　　者：徐桂霞[1] 安科颖[1] 于玲[1] 费腾[1] 申莹莹[1] 

机构地区：[1]黑龙江省医院,黑龙江哈尔滨150036

出　　处：《黑龙江医学》2012年第5期329-331,341,共4页Heilongjiang Medical Journal

摘　　要：目的了解我院自2005年以来,近6年产超广谱β内酰胺酶大肠埃希菌的耐药变化情况,从而为临床合理使用抗生素提供指导。方法对2005～2010年,6年间临床分离的大肠埃希菌共计619株菌进行药敏分析,采用K-B法进行药敏试验,ESBLs筛选试验及确认试验按照美国CLSI相关标准进行,结果用WHONET 5.4软件进行数据统计分析。结果 6年来,大肠埃希菌产ESBLs阳性率从45.5%上升至68.4%。6年分离的大肠埃希菌合计产ESBLs率为56.1%。产ESBLs株对头孢菌素类、氟喹诺酮类等常用抗生素药物的耐药率明显高于非产ESBLs株,对碳青霉烯类抗菌药物敏感,氨基糖苷类抗生素在所有大肠埃希菌中耐药率呈增长趋势。结论 6年来,大肠埃希菌中ESBLs阳性率逐年升高,并呈现出多重耐药性,对产ESBLs菌株的治疗应首选碳青霉烯类抗生素药物。虽然这次监测没有发现耐碳青霉烯类的菌株,但是也应引起重视。氨基糖苷类抗生素在所有大肠埃希菌中耐药率呈增长趋势,这需要我们进一步研究是否有新的耐药机制存在。Objective To investigate and analyse the isolation rate and antibiotic resistance rate of extended spectrum beta-lactamases（ESBLs） producing Escherichia coli nearly 6 years from 2005 in our hospital for correct and reasonable use of antibiotics.Methods Escherichia coli isolated from clinical samples of our hospital from 2005 to 2010 were detected by the Kirby-Bauer method and the data were analyzed by the software of WHONET5.4.Results The positive rates of ESBLs producing E.coli increased from 45.5% to 68.4%,respectively.The ESBLs producing isolates displayed multi-drug resistance to cephalosporins and quinolones.The drug resistance rate was significantly higher than that of the ESBL s non-producing isolates,but both of them were still highly sensitive to carbopenems.Conclusion The positive rates of ESBLs producing E.coli in our hospital were increasing gradually in the past four years and they exhibited multi-drug resistance.Carbopenems antibiotics should be applied firstly to treat the related infections.

关 键 词：大肠埃希菌 超广谱Β-内酰胺酶 耐药性 

分 类 号：R446[医药卫生—诊断学]