2008-2012年大肠埃希菌的临床分布特征及耐药性变迁  

Analysis of the clinical distribution and drug resistance of Escherichia coli from 2008 to 2012

作　　者：胡景玉[1] 杜红丽[1] 乔艳梅[1] 吴妍[1] 杨世金[2] 

机构地区：[1]衡水哈励逊国际和平医院检验科,河北衡水053000 [2]衡水哈励逊国际和平医院贵宾病房,河北衡水053000

出　　处：《现代预防医学》2014年第22期4130-4132,共3页Modern Preventive Medicine

摘　　要：目的探讨大肠埃希菌的临床分布特征及耐药性变迁,指导临床医生合理使用抗菌药物。方法采用HX-21细菌鉴定分析仪和VITEK-2全自动细菌鉴定及药敏分析仪对2008年1月-2012年12月某院检出的大肠埃希菌(ECO)进行鉴定及药敏分析。结果 1 207株大肠埃希菌共检出产超广谱酶β-内酰胺酶(ESBLs)菌579株,检出率为48.0%。药敏结果显示:头孢唑啉、头孢曲松、头孢呋辛和氨苄西林耐药率上升最为显著,分别从2008年的70.2%、68.4%、66.7%和80.7%升高到2012年的93.9%、85.5%、91.6%和95.2%。哌拉西林/他唑巴坦耐药率5年均<10%,亚胺培南和美罗培南耐药率最低<2%,仍是临床治疗大肠埃希菌感染特别是产ESBLs菌的首选药物。结论大肠埃希菌耐药率逐年上升,并呈现多重耐药现象,所以临床应重视病原菌检测,避免经验性用药。Objective This work was to investigate the clinical distribution and drug resistance of clinical Escherichia coli, and provide guidance for the rational use of antibiotics. Methods HX-21 bacterial identification instrument and the VITEK-2 automatic bacteria identification and drug sensitivity analyzer were used for the corresponding analysis of Escherichia coli collected in our hospital during 2008-2012. Results 579 extended spectrum beta lactamase （ESBL） producing E.coli were detected from a total of 1207 E. coli isolates, with a positive rate of 48%. The drug sensitivity results showed that the drug resistance rate to cefazolin, cefuroxime, ceftriaxone and ampicillin increased most significantly, from 70.2%, 68.4%, 66.7%, 80.7% in 2008 to 93.9%, 85.5%, 91.6%, 95.2% in 2012, respectively. In the five years, the average drug resistance of piperacillin / tazobactam was 〈10%, and that of imipenem and meropenem was the lowest （〈2%）, therefore they are still the primary drugs for infections by ESBL producing E.coli. Conclusion E. coli resistance increased year by year, with growing cases of multidrug resistance. Therefore, clinical pathogen detection should be strengthened and empirical therapy should be reduced.

关 键 词：大肠埃希菌 超广谱Β-内酰胺酶 耐药性 变迁 

分 类 号：R378[医药卫生—病原生物学]