产ESBL大肠埃希菌在血流感染中的流行及危险因素分析  

Prevalence and risk factors analysis of ESBL-producing Escherichia coli in bloodstream infections

作　　者：郭亮 张传领[2] GUO Liang;ZHANG Chuan-ling(The Affiliated Hospital of Hangzhou Normal University,Hangzhou,Zhejiang 310015,China)

机构地区：[1]杭州师范大学附属医院,浙江杭州310015 [2]浙江萧山医院,浙江杭州311201

出　　处：《中国卫生检验杂志》2018年第17期2103-2106,共4页Chinese Journal of Health Laboratory Technology

摘　　要：目的了解血流感染中产ESBL大肠埃希菌的流行情况,分析其致血流感染危险因素,为临床抗感染治疗提供实验室证据。方法收集浙江萧山医院2012年1月-2016年12月血流感染中分离的大肠埃希菌,进行细菌鉴定和药物敏感试验;对产ESBLs大肠埃希菌感染进行危险因素分析。结果共分离到236株大肠埃希菌,其中产ESBLs菌株占47.9%,对庆大霉素、氨苄西林、环丙沙星、左氧氟沙星、复方新诺明、头孢他定、头孢噻肟、头孢吡肟耐药率较高(>50%),对磷霉素、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦及阿米卡星耐药率较低(<10%)。产ESBLs大肠埃希菌引起血流感染的危险因素包括基础疾病、泌尿系梗阻性疾病、恶性肿瘤、近3个月内住院史、近3个月内抗菌药物使用。结论血流感染中大肠埃希菌产ESBL比率较高,产ESBLs大肠埃希菌引起血流感染的危险因素较多,临床用药过程中应注意评估危险因素。Objective To investigate the epidemic of ESBLs-producing Escherichia coli in bloodstream infections. And to analyze the risk factors of ESBLs-producing Escherichia coli infections,in order to provide laboratory evidence to the clinical.Methods The Escherichia coli in bloodstream infections were collected from January 2012 to December 2016 in Xiaoshan Hospital for bacterial identification and drug sensitivity test. The risk factors of ESBLs-producing Escherichia coli infections were analyzed. Results A total of 236 pathogens were collected,and Escherichia coli producing ESBLs accounted for 47. 9%. ESBLs-producing Escherichia coli strains were resistant to gentamycin,ampicillin,ciprofloxacin,levofloxacin,cotrimoxazole,ceftazidime,cefotaxime and cefepime（ with the positive rate more than 50%）. The resistance rate to fosfomycin,piperacillin/tazobactam,cefoperazone/sulbactam and amikacin was low（ 10%）. The risk factors of bloodstream infection caused by ESBLs-producing Escherichia coli included basic diseases,obstructive urinary tract disease,malignant neoplasms,hospital history in nearly 3 months and the antimicrobial use in nearly 3 months. Conclusion ESBLs-producing Escherichia coli in bloodstream infection has high detection rate,and there are many risk factors of bloodstream infections caused by ESBLs-producing Escherichia coli. We should assess the risk factors in the course of clinical medication.

关 键 词：大肠埃希菌 耐药性 血流感染 

分 类 号：R446.5[医药卫生—诊断学]