大肠埃希菌的分布及耐药性分析  

Distribution of Escherichia coli and analysis of drug resistance

作　　者：陈国敏[1] 王东辰[2] 李晓霞[3] 申宝鸣[4] 王化芬[1] 

机构地区：[1]解放军第88医院检验科,山东泰安271000 [2]解放军第88医院骨科中心,山东泰安271000 [3]泰山医学院病原学生物学教研室,山东泰安271000 [4]新汶矿业集团中心医院检验科,山东泰安271219

出　　处：《中华医院感染学杂志》2014年第10期2356-2357,2404,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学青年基金资助项目(81101307)

摘　　要：目的了解医院大肠埃希菌的耐药性及其分布特点，为临床治疗及控制感染提供依据。方法对2011年1月-2012年12月568株大肠埃希菌的分布及耐药率进行回顾性分析；采用法国生物梅里埃公司半自动细菌鉴定仪ATBExpression进行菌株鉴定，采用K-B法进行药敏试验，结果按美国临床实验室标准化委员会（NC-CLS）2010年标准进行判读。结果568株大肠埃希菌主要分离自尿液和痰液标本，分别占34．0％和28．9％；大肠埃希菌对亚胺培南和美罗培南的耐药率均为0；对哌拉西林／他唑巴坦、头孢西丁、阿米卡星、头孢他啶、米诺环素、头孢吡肟、氨苄西林／舒巴坦、替卡西林／克拉维酸、妥布霉素的耐药率在8．9％～56．8％，对庆大霉素、头孢噻肟、左氧氟沙星、环丙沙星、头孢呋辛、头孢唑林、磺胺甲嗯唑／甲氧苄啶、哌拉西林和氨苄西林的耐药率在60．9％～84．3％。结论大肠埃希菌是泌尿道和呼吸道感染的常见病原菌，临床上应首选哌拉西林／他唑巴坦、头孢西丁、米诺环素和阿米卡星进行抗感染治疗。OBJECTIVE To investigate the drug resistance and distribution characteristics of Escherichia coli （E. coil） in the hospital so as provide evidence for clinical treatment and infection control. METHODS The distribution and drug resistance rates of 568 strains of E. coli collected from Jan 2011 to Dec 2012 were retrospectively ana- lyzed; BioMerieux semi-automatic bacteria identification analyzer （ATB Expression） was adopted for bacteria iden- tification, Kirby-Bauer method was adopted for drug sensitivity test, and the results were determined as per the standard of National Committee for Clinical Laboratory Standards （NCCLS） issued in 2010. RESULTS The 568 strains of E. coil were mainly isolated from urine（34.0%） and sputum（28.9%） specimens. Both of the resistance rates of the E. coli to imipenem and meropenem were 0; the resistance rates to piperacillin-tazobactam, cefoxitin, amikacin, ceftazidime, minocycline, cefepime, ampicillin-sulbaetam, tiearcillin-elavulanic acid, and tobramycin varied from 8.9 % to 56.8 % ; the resistance rates to cidomycin, cefotaxime, levofloxacin, ciprofloxacin, cefuroxime, cefazolin, sulfamethoxazole-trimethoprim,piperacillin and ampicillin varied from 60.9% to 84. 3 %. CONCLUSION E. coli is a type of common pathogen causing urinary tract infections and respiratory tract infections. It is required to take piperacillin-tazobactam, cefoxitin, minocycline and amikacin as first choice in clinical practice for anti-infec- tive therapy.

关 键 词：大肠埃希菌 耐药率 抗菌药物 分布 

分 类 号：R378.21[医药卫生—病原生物学]