大肠埃希菌感染的临床分布与耐药性分析  

Distribution and drug resistance of Escherichia colicausing infections

作　　者：张淑青[1] 王贺永[1] 李宏芬[1] 张树春[1] 

机构地区：[1]开滦医院检验科,河北唐山063000

出　　处：《中华医院感染学杂志》2012年第15期3385-3386,3429,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析大肠埃希菌感染的临床分布特点及耐药性,为临床合理应用抗菌药物提供科学依据。方法采用常规方法分离大肠埃希菌,全自动细菌鉴定仪VITEK-2Compact进行细菌的鉴定,纸片扩散法(K-B法)做药敏试验,用WHONET 5.4软件进行分析。结果分离的775株大肠埃希菌,来自临床送检的各类标本,主要以痰液、尿液及脓液标本为主,分别占43.1%、28.8%及11.5%;大肠埃希菌产超广谱β-内酰胺酶(ESBLs)检出率为63.7%;药敏结果显示,大肠埃希菌对亚胺培南和美罗培南敏感率为100.0%,对头孢替坦、阿米卡星、哌拉西林/他唑巴坦、呋喃妥因耐药率较低,对青霉素类、头孢菌素类及氨曲南耐药率均>60.0%,产ESBLs菌株对抗菌药物的耐药率大部分高于非产ESBLs菌株。结论大肠埃希菌对常用抗菌药物耐药性严重,应加强耐药性监测。OBJECTIVE To investigate the distribution and resistance characteristics of Escherichia coli in order to provide scientific basis for the clinical application of drugs. METHODS The isolates of E. coli were isolated from clinical samples by routin methods, the pathogenic bacteria were identified with VITEK-2 compact, drug susceptibility test was carried out by using K-B method, and the test results were analyzed with WHONET 5.4 software. RESULTS A total of 775 E. coli strains were isolated from various submitted specimens including sputum （43. 1%）, urine （28. 8%）, and pus （11. 5%）; the detection rate of extended-spectrum β-1actamases （ESBLs） producing E. coli was 63. 7% ; the result of drug susceptibility testing indicated that the drug susceptibility rates of E. coli to imipenem and meropenem were 100. 0%, and the resistance rates to cefotetan, amikacin, piperacillin/tazobactam, and nitrofurantoin was tow, the resistance rate to penicillins, cephalosporins, and aztreonam was over 60.0%, the resistance rates of most of the ESBL-producing stains were higher than those of the non -ESBL-producing strains. CONCLUSION Drug resistance of E. coli to common antibiotics is serious, it is necessary to strengthen surveillance for drug resistance.

关 键 词：大肠埃希菌 超广谱Β-内酰胺酶 耐药率 

分 类 号：R378.21[医药卫生—病原生物学]