埃希菌属在临床标本中的检出及耐药性  

Detection and drug resistance of Escherichiafrom clinical samples

作　　者：储从家[1] 孔繁林[1] 管新龙[1] 李杰芬[1] 杨宇溪[1] 

机构地区：[1]玉溪市人民医院检验科,云南玉溪653100

出　　处：《中华医院感染学杂志》2013年第5期1157-1159,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查某医院埃希菌属在临床标本中的检出及耐药性,为防治大肠埃希菌感染提供依据。方法回顾性分析该院2003-2010年临床各科送检标本分离的3270株埃希菌属临床和实验室资料。结果 8年临床送检82212份标本,共分离出埃希菌属3270株,总分离率3.98%,年度分离率呈上升趋势(χ2=84.17,P<0.01);菌株分布以尿液标本最多,但血液感染最为严重;产ESBLs大肠埃希菌检出率高达63.89%;药敏结果其对氨苄西林、阿莫西林/克拉维酸、替卡西林和萘啶酸等呈高度耐药和多药耐药,且耐药率呈上升趋势(P<0.01);大肠埃希菌产ESBLs株和非产ESBLs株差异有统计学意义(P<0.01);亚胺培南、呋喃妥因和头孢西丁耐药率均相对较低,<10.0%。结论大肠埃希菌在临床标本中检出的增多以及对某些β-内酰胺青霉素和头孢类抗菌药物耐药率的迅速上升,对大肠埃希菌感染的防治十分不利,应引起临床的高度关注。OBJECTIVE To investigate the detection and drug resistance of Escherichia coli from clinical samples,so as to provide evidence for the prevention of E.coli infections.METHODS Retrospective analysis was performed for the clinical and experimental data of 3270 strains of Escherichia isolated from clinical departments between 2003 to 2010.RESULTS Totally 3270 strains of Escherichia were isolated from 82 212 submitted clinical samples,the isolation rate was 3.98%.The increment of yearly isolation rate was prominent in 8 years（χ2=84.17,P0.01）.The distribution of detective strain was the most in urine samples.But the results was the most severe in infection of bloodstream.The detection rate of ESBLs-producing E.coli uplifted to 63.89%.The drug susceptibility testing indicated that the E.coli strains were highly resistant to ampicillin,amoxicillin/ciavulanic acid,ticarcillin and nalidixic acid and were multidrug-resistant,the drug resistance rate kept an upward tendency.The difference between the ESBLs-producing E.coli and the non-ESBLs-producing E.coli was statistically significant（P0.01）.The drug resistances rates to imipenem,nitrofurantion,and cefoxitin were relatively low,with the drug resistance rates lower than 10.0%.CONCLUSION E.coli isolated from clinical samples has been increased and the drug resistance to some β-lactam and cephalosporin antibiotics increases rapidly,which is unfavorable for the prevention of E.coli infections,thus the hospital should pay high attention to it.

关 键 词：大肠埃希菌 超广谱Β-内酰胺酶 耐药性 

分 类 号：R378[医药卫生—病原生物学]