某医院大肠埃希菌的临床分布与耐药性分析  

Clinical Distribution and Drug Resistance of Escherichia Coli in a Hospital

作　　者：褚福立 赵秀英 张东军[2] 李玉民[2] 

机构地区：[1]山东省巨野县大义中心卫生院,山东巨野274933 [2]山东省寄生虫病防治研究所

出　　处：《寄生虫病与感染性疾病》2017年第1期17-20,共4页Parasitoses and Infectious Diseases

摘　　要：目的分析大肠埃希菌在临床感染的分布特点及耐药性,为临床合理选择抗菌药物提供理论参考。方法2013-05/2015-05山东省巨野县大义医院对210株临床标本分离的大肠埃希菌的分布进行回顾性分析,细菌药敏试验采用K-B纸片扩散法,PCR法检测耐药基因分布情况。结果各种临床标本中共分离出病原菌1 595株,其中大肠埃希菌210株,占13.17%;大肠埃希菌主要分离自中段尿、痰液、分泌物、血液及咽拭子,分别占分离株构成比的30.48%、21.43%、19.05%、13.33%和5.71%;产ESBLs大肠埃希菌总检出率为60.95%(128/210),其中以痰标本检出率最高,为82.22%。大肠埃希菌对亚胺培南和美罗培南敏感率均为100.0%;对厄他培南、阿米卡星、头孢西丁、头孢哌酮均敏感,总耐药率分别为1.9%、9.5%、9.5%和14.3%;对青霉素类、三代头孢菌素类及喹诺酮类药物耐药率高,产ESBLs大肠埃希菌的耐药性显著高于非产耐药性的大肠埃希菌。结论山东省巨野县大义医院临床分离大肠埃希菌耐药率较高,临床应根据药敏试验结合患者病情选择抗菌药物。Objective To analyze the distribution features and drug resistance of Escherichia coli in clinic,and provide a theoretical reference for rational antibiotics therapy. Methods A retrospective analysis was used to investigate the distribution of Escherichia coli isolated from 210 clinical samples. The drug sensitivity test was carried out by K-B disk diffusion method and PCR method was used to detect the distribution of drug resistance genes. Results Various clinical specimens of the Communist Party of China（ CPC） isolated from 1 595 strains of pathogenic bacteria,including 210 strains of Escherichia coli,accounted for 13. 17%; Escherichia coli separation was main from urine,sputum,secretion,blood and throat swabs,which accounted for isolates constituent ratio of 30. 48%,21. 43%,19. 05%,13. 33% and 5. 71% respectively; ESBLs producing Escherichia coli total detection rate was 60. 95%（ 128/210）,its detection rate was the highest in specimen of sputum for 80. 22%. Escherichia coli sensitive rate for imipenem and meropenem were 100. 0%; for ertapenem,amikacin,cefoxitin,cefoperazone were sensitive,total drug resistance rate was 1. 9%,9. 5%,9. 5% and14. 3% respectively; for penicillins,the third generation cephalosporins and quinolones the drug resistance rate was high,the drug resistance of ESBLs producing Escherichia coli was significantly higher than that of non production of Escherichia coli. Conclusion At present,the clinical isolates of Escherichia coli drugresistance rate is increasing. The antibiotics therapy should be based on the drug sensitivity test combined with the individual conditions.

关 键 词：大肠埃希菌 医院感染 临床分布 耐药率 

分 类 号：R378.2[医药卫生—病原生物学]