204株大肠埃希菌感染的临床分布及耐药性分析  

Clinical Distribution and Resistance of 204 Escherichia Coli Strains

作　　者：黄进凤 涂秀英[1] 

机构地区：[1]重庆市巴南区第二人民医院,重庆400054

出　　处：《中国药业》2016年第18期34-36,共3页China Pharmaceuticals

摘　　要：目的了解医院大肠埃希菌感染的临床分布及耐药情况,为临床合理用药提供参考。方法回顾性分析2014年至2015年医院临床分离的204株大肠埃希菌的标本来源及药物敏感性(简称药敏)试验结果。结果 204株大肠埃希菌标本主要来源于脓液(31.37%)、痰液(28.43%)和尿液(13.73%),有90株大肠埃希菌产超广谱β-内酰胺酶(ESBLs),产酶率为44.12%,产酶菌株的耐药性较非产酶菌株严重;产酶菌株对氨苄西林和哌拉西林完全耐药,对第1~3代头孢菌素类的耐药率达95.00%以上,对头孢吡肟、氨曲南、庆大霉素、环丙沙星、氧氟沙星、左氧氟沙星、复方新诺明的耐药率均在50.00%以上,但对亚胺培南、哌拉西林他唑巴坦、头孢哌酮舒巴坦、阿米卡星、呋喃妥因的耐药率较低,分别为1.11%,2.22%,2.22%,5.56%,8.89%。结论大肠埃希菌是医院呼吸道、泌尿道和外科感染的常见病原菌,产酶菌株的耐药性较严重,临床应加强其耐药性监测,根据药敏试验结果合理选择敏感的抗菌药物。Objective To investigate the clinical distribution and drug resistance of Escherichia coli infection in the hospital to provide the reference for the clinical rational drug use. Methods The retrospective analysis was conducted with the sources and drug sensitivity test results of the 204 strains of Escherichia coli isolated from 2014 to 2015. Results The 204 strains of Escherichia coli samples were mainly from the pus（31.37% ）,sputum（28.43% ） and urine（13.73% ）,90 strains of Escherichia coli produced extended spectrum lactamases（^-ESBLs）,the enzyme production rate was 44.12% and the drug resistance of enzyme producing strain was more serious than non enzyme producing strain;enzyme producing strain was 100.00% resistant to ampicillin and piperacillin, and the resistant rates of first to third - generation cephalosporins were above 95.00% ,and resistance rates to cefepime,aztreonam,gentamicin,ciprofloxaein,lev- ofloxacin, and co - trimoxazole were above 50.00% , but the resistant rates of imipenem, piperacillin/tazobactam, cefoperazone/sulbactam, amikacin,and nitrofurantoin were lower, i.e. ,1.11% ,2.22% ,2.22% ,5.56% ,8.89%.Conclusion Escherichia coli is a common pathogen of urinary tract infections and surgery in the hospital and drug resistance rate of respiratory tract infection, enzyme producing strains is more serious. The clinic should strengthen its monitoring of drug resistance according to the results of drug sensitive test, and make reasonable selection of sensitive antibiotics.

关 键 词：大肠埃希菌 临床分布 耐药性 超广谱Β-内酰胺酶 

分 类 号：R969.3[医药卫生—药理学] R978.1[医药卫生—药学]