产超广谱β-内酰胺酶大肠埃希菌的临床特点及耐药监测  

Analysis of drug resistance and clinical significance of ESBLs-producing Escherichia coli

作　　者：林丽英[1] 郭旭光[1] 邓穗燕[1] 陈琼[1] 陈金桃[1] 夏勇[1] 

机构地区：[1]广州医科大学附属第三医院检验科,510150

出　　处：《国际检验医学杂志》2016年第11期1459-1461,共3页International Journal of Laboratory Medicine

基　　金：广东省广州市医药卫生科技一般引导资助项目(20151A011083)

摘　　要：目的监测广州医科大学附属第三医院2014年和2015年大肠埃希菌的分离情况及其对抗菌药物的耐药状况,为临床合理使用抗菌药物提供依据。方法常规方法培养分离患者感染的病原菌,并采用全自动细菌鉴定分析仪鉴定到种,药敏试验方法按CLSI规定的标准进行,采用WHONET5.6软件进行数据统计分析。结果 2014年和2015年共分离到大肠埃希菌1 202株,标本分布前5位分别为尿液、血液、痰液、分泌物和组织,本次分离得到的大肠埃希菌对替加环素敏感率为99.9%,对亚胺培南敏感率为99.2%,对阿米卡星敏感率为97.7%,对哌拉西林/他唑巴坦敏感率为97.2%,对呋喃妥因敏感率为85.2%。2014年和2015年分离得到的产超广谱β-内酰胺酶(ESBLs)大肠埃希菌阳性菌共643株,占53.5%。2年分离得到的ESBLs阳性的大肠埃希菌对头孢曲松、氨苄西林、头孢唑啉耐药率达99.0%;而对亚胺培南、替加环素、阿米卡星、哌拉西林/他唑巴坦、呋喃妥因敏感率达80.0%以上。结论大肠埃希菌对多种抗菌药物的耐药趋势相对稳定,临床微生物实验室应加强对多重耐药菌株的监测,为临床合理使用抗菌药物提供依据。Objective To analyze the drug resistance of extended spectrumβ-lactamases（ESBLs）-producing Escherichia coli,and to provide evidence for reasonable use of antibiotics in clinic.Methods Gram-negative bacilli were isolated from various infected specimens from the inpatients from 2014 and 2015.Isolation and identification of the strains were performed according to National Clinical Laboratory Operation Rule.And by automatic analyzer,the strains were identified.Drug sensitivity testing was performed by micro-broth dilution method.Data were statistically analyzed by WHONET5.6software.Results Between 2014 and 2015,1202 strains of Escherichia coli were isolated from samples of urine,blood,sputum,secretion and tissue.The sensitive rates of Escherichia coli for tigecycline,imipenem,amikacin,piperacillin/tazobactam and nitrofurantoin were 99.9%,99.2%,97.7%,97.2% and85.2%.643 strains of ESBLs-producing Escherichia coli were isolated,which accounted for 53.5% of the total strains.The resistant rate of ESBLs-producing Escherichia coli for ceftriaxone,ampicillin and cefazolin was up to 99% and the sensitive rate for tigecycline,amikacin,piperacillin,piperacillin/tazobactam and nitrofurantoin was over 80%.Conclusion Drug resistance status of gramnegative bacilli is very serious.It should pay attention to the detection of pathogens and drug resistance of the bacteria in hospital.

关 键 词：超广谱Β-内酰胺酶 大肠埃希菌 耐药监测 

分 类 号：R446.5[医药卫生—诊断学]