产超广谱β-内酰胺酶大肠埃希菌的临床感染分布及耐药性分析  

Distribution of Extended-spectrum-β-lactamases-producing Escherichia coli and its Antibiotic Resistance Analysis

作　　者：陈丽[1] 杨卫萍[1] 

机构地区：[1]江汉大学附属医院检验科,湖北武汉430015

出　　处：《江汉大学学报（自然科学版）》2013年第6期76-78,共3页Journal of Jianghan University：Natural Science Edition

摘　　要：目的-探讨医院产超广谱β-内酰胺酶（ESBLs）大肠埃希菌的临床感染分布及耐药情况，为临床抗感染治疗合理选择抗生素、减少耐药发生提供依据。方法：收集2010年8月-2011年12月从临床送检标本中分离的大肠埃希菌264株，药敏试验采用K～B纸片扩散法。根据美国临床检验室标准化委员会（CLSI）推荐的纸片扩散法，严格按照其制定的标准进行ESBLs确证实验。采用wHONET5．4软件进行统计学分析。结果：264株大肠埃希菌中检出134株（50．8％）产ESBLs大肠埃希菌，标本分布以痰标本最高（47．76％），而科室分布以普外科最高（12．61％）。在药敏实验中，产ESBLs菌株对亚胺培南、美罗培南、头孢哌酮／舒巴坦、阿米卡星、哌拉西林／他唑巴坦、呋喃妥因、头孢西丁的耐药性较低（0％。15．5％）：环丙沙星、左氧氟沙星、庆大霉素、复方新诺明，阿莫西林／克拉维酸的耐药性较高（41.3％～82．8％）；青霉素类、头孢菌素类及ATM耐药性高（100％），临床不宜选用。结论：产ESBLs大肠埃希菌存在多重耐药性，临床实验室应加强产ESBLs菌株的监测，根据，临床药敏结果合理选用抗生素。Objective： To explore the distribution and antibiotic resistance of extended-spec- trum-β-1actamases （ESBLs）-producing Eseheriehia eoli in the hospital, so as to provide reference for reasonable utilization of antibiotic and reducing of drug resistance. Methods ： From Aug, 2010 to Dec, 2011,264 E.colis were isolated from clinical specimens, the antibiotic susceptibility was test- ed by K-B method. According to CLSI standard, ESBLs was confirmed, statistical analysis was tak- en with WHONET 5.4 software. Results： Among 264 E.coli isolates, 134（50.8%） were ESBLs-pro- ducing strains. The sputum was the highest sources of specimens （47.76%）, the department of gen- eral surgery was the highest section-office of distribution （12. 61% ）. The resistance rates for ES- BLs-producing E.coli to imipenem, meropenem, piperacillin/tazobactam, cefoperazone/sulbactam, amikacin, cefoxitin and nitrofurantoin were lower and between 0% to 15.5% ; The resistance rates to ciprofloxacin, levofloxacin, gentamicin, compound sulfamethoxazole and amoxicillin/elavulanate were higher and between 41.3% to 82.8% ; The resistance rates to penicillins, cephalosporins and aztreonams were highest and reached 100%, so they are not suitable for clinic. Conclusion： ES- BLs-producing E.coli has multidrug-resistant, clinical laboratory, to use antibiotics according so it is necessary to strengthen the surveillance in to antibiotic susceptibility test.

关 键 词：产超广谱Β-内酰胺酶 大肠埃希菌 耐药性 监测 

分 类 号：R446.5[医药卫生—诊断学] R197.323.4[医药卫生—临床医学]