ICU与非ICU大肠埃希菌的耐药性分析  

Analysis of drug resistance of Escherichia coli in ICU and non ICU departments

作　　者：曹爱国[1] 路丽娜 CAO Ai-guo, LU Li-na.(fining Traditional Chinese Medicine Hospital, Jining 272100, China)

机构地区：[1]济宁市中医院,272100 [2]济宁市第一人民医院,272011

出　　处：《中国实用医药》2018年第29期193-194,共2页China Practical Medicine

摘　　要：目的了解医院大肠埃希菌(E.coli)感染的临床分布和耐药分析,为临床合理性用药提供依据。方法 1911株E.coli,其中重症监护病房(ICU) 414株,非ICU 1497株。应用法国生物梅里埃全自动微生物鉴定仪进行鉴定,并做临床常用抗菌药物的耐药性分析。结果 (1) E.coli分布:共分离出E.coli1911株,其中ICU分离出414株(21.66%),非ICU分离出1497株(78.34%)。(2)标本分布:其中尿液标本最多,占38.40%(734/1911),其次痰液18.90%(361/1911)、分泌物15.60%(298/1911)、血液12.56%(240/1911)、脓液5.18%(99/1911)、腹水3.61%(69/1911)、胆汁2.77%(53/1911)、穿刺液1.57%(30/1911)、其他0.78%(15/1911)、胸水0.63%(12/1911)。(3) E.coli的药敏试验结果 :1911株E.coli对抗生素厄他培南、亚胺培南、美罗培南等抗菌药物的耐药率较低, ICU分别为3.62%(15/414)、2.42%(10/414)、2.17%(9/414),非ICU分别为1.67%(25/1497)、0.73%(11/1497)、0.87%(13/1497),而对其他抗生素均有较高的耐药率;ICU与非ICU的厄他培南、亚胺培南、美罗培南等抗菌药物的耐药率比较差异均具有统计学意义(P<0.05)。结论与非ICU比较, ICU中检出的E.coli具有较高的耐药率;临床应合理选用抗菌药物,积极采取各种医疗手段,防止耐药的E.coli(尤其是ICU)在院内的播撒。Objective To understand the clinical distribution and drug resistance of Escherichia coli（E. coli） infection in hospitals, and to provide basis for the reasonable clinical of antibiotics. Methods 1911 strains of E.coli, including 414 strains of intensive care unit（ICU）, 1497 strains of non-ICU, were selected. The identification was carried out by using the French biology-biomerieux bacterial automatic identification system and the resistance analysis of commonly used antimicrobial agents in clinic was performed. Results（1） Distribution of E. coli： A total of 1911 strains of E. coli were isolated. 414 strains（21.66%） were isolated from ICU and 1497 strains（78.34%） were isolated from non-ICU.（2） Distribution of specimens： urine specimens accounted for 38.40%（734/1911）, sputum specimens accounted for 18.90%（361/1911）, secretion specimens accounted for 15.60%（298/1911）, blood specimens accounted for 12.56%（240/1911）, pus specimens accounted for 5.18%（99/1911）, ascites specimens accounted for 3.61%（69/1911）, bile specimens accounted for 2.77%（53/1911）, puncture fluid specimens accounted for 1.57%（30/1911）, the other specimens accounted for 0.78%（15/1911） and pleural effusion specimens accounted for 0.63%（12/1911）.（3） Drug susceptibility test of E. coli showed that the drug resistance rate of 1911 strains of E. coli to antibiotics such as Ertapenem, Imipenem and Meropenem were low, in ICU were 3.62%（15/414）, 2.42%（10/414） and 2.17%（9/414） respectively, in non-ICU were 1.67%（25/1497）, 0.73%（11/1497） and 0.87%（13/1497） respectively, the resistance rates to other antibiotics were high. There were significant differences in drug resistance rates of Ertapenem, Imipenem and Meropenem between ICU and nonICU groups（P〈0.05）. Conclusion Compared with the non-ICU, detection of E.coli in the ICU has high resistance. It is suggested to choice the reasonable antibiotics, take all kinds of medical treatment and prevent the spread of

关 键 词：大肠埃希菌 重症监护病房 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]