秀山土家族苗族自治县大肠埃希菌耐药性的流行趋势及防控措施研究  

Epidemic trend and research on prevention and control measures of Escherichia coli resistance in miao autonomous county of Tujia and Miao Nationality Xiushan Autonomons County

作　　者：张羽锋 刘双娟 刘诗平 ZHANG Yufeng;LIU Shuangjuan;LIU shiping(De-partmeng of Clinical Laboratory,People＇s Hospital of Xiushan County,Chongqing 409900,China)

机构地区：[1]秀山县人民医院检验科,重庆409900

出　　处：《现代医药卫生》2018年第13期1989-1991,1994,共4页Journal of Modern Medicine & Health

摘　　要：目的了解秀山土家族苗族自治县(秀山县)大肠埃希菌的耐药性流行趋势,提出防控措施以指导临床医生合理使用抗生素。方法收集2014年1月至2016年6月临床分离的大肠埃希菌656株,采用药敏系统和纸片扩散(κ-B)法及其配套试剂进行细菌鉴定和药敏试验,数据采用全国细菌耐药监测网秀山县人民医院2014年1月至2016年6月上报的数据进行统计分析。结果 656株大肠埃希菌在尿液中分离率最高,占44.5%,产超广谱β-内酰胺酶(ESBLs)大肠埃希菌的检出率为54.3%。大肠埃希菌对19种抗菌药物的耐药性情况:对2~4种抗菌药物的耐药率大于75.0%,对6~8种抗菌药物的耐药率大于50.0%,对7~9种抗菌药物的耐药率小于30.0%,其中大肠埃希菌对碳青霉烯类抗菌药物如亚安培南等仍高度敏感,其耐药率在1.0%左右。结论秀山县临床分离的大肠埃希菌对多种抗菌药物耐药率较高,特别是产ESBLs大肠埃希菌的高耐药率及多重耐药性更为明显。微生物室、院感科、药学科应多科合作,加强大肠埃希菌耐药性的监测并防治多重耐药菌的传播流行。Objective To understand the trend of resistance of Escherichia coli in the Tujia and Miao Nationality Xiushan Autonomous County （Xiushan County）, to put forward prevention and control measures and to guide clinicians to ratio-nally use antibiotics. Methods Totally 656 strains of Escherichia coli isolated from clinical in January 2014 to June 2016 were collected. The identification system and the paper diffusion （K-B） and the matching reagent for bacterial identification and drug test were used. The data were statistically analyzed using data from CARSS, the national bacterial resistance monitor-ing network of People＇s Hospital of Xiushan County in January 2014 to June 2016. Results 656 strains of Escherichia coli in urine separation rate was the highest, accounted for 44.5%, the detection rate of ESBLs was 54.3%. Escherichia coli to 19 kinds of antimicrobial resistance of： for 2-4 kinds of antimicrobial drug resistant rates were more than 75.0%, for 6-8 kinds of antimi- crobial drug resistant rates were more than 50.0%, for 7-9 kinds of antimicrobial drug resistance rates were lesser than 30.0%, including Escherichia coli on carbon penicillium alkene antimicrobial agents remained highly sensitive, the drug resistance was around 1.0%. Conclusion The clinical isolation of Escherichia coli in xiushan county has high drug resistance rate of vari- ous antimicrobial agents, especially the high drug resistance rate and multiple drug resistance of ESBLs Escherichia coll. The microorganism room, the sense division of the hospital and the medicine subject shall cooperate to strengthen the monitoring of Escherichia coli resistance and prevent the spread of multidrug-resistant bacteria.

关 键 词：大肠杆菌 药物耐受性 微生物敏感性试验 超广谱Β内酰胺酶 多重耐药菌 防治 

分 类 号：R446.5[医药卫生—诊断学]