2015—2017年某院产超广谱β内酰胺酶大肠埃希菌耐药性及其所致感染性疾病的危险因素分析  

Anabysis on Drug resistance and risk factors of extended-spectrum β-lactamases in escherichia coli infections in the hospital from 2015 to 2017

作　　者：赵玉杰 王丽 吕艳关 ZHAO Yujie;WANG Li;Lyv Yanguan(Laboratory of Clinical Medicine,Huai＇an Women ＆Children Hospital,Affiliated to Yangzhou University,Huai＇an,Jiangsu 223002,China)

机构地区：[1]扬州大学附属淮安市妇幼保健院医学检验科,江苏淮安223002

出　　处：《现代医药卫生》2018年第21期3315-3317,共3页Journal of Modern Medicine & Health

摘　　要：目的分析近3年医院内感染产超广谱β内酰胺酶(ESBLs)肠杆菌科细菌的分布,产ESBLs大肠埃希菌的耐药性及其所致感染的危险因素。方法对2015—2017年该院临床标本中分离的1 826株肠杆菌科菌进行鉴定和药敏试验分析。病例对照研究ESBLs大肠埃希菌引起感染的危险因素。结果 1 826株肠杆菌科菌中,549株(30.1%)产ESBLs。大肠埃希菌和克雷伯菌属是主要的ESBLs肠杆菌科菌。尿液是ESBLs大肠埃希菌的主要标本来源,其次是痰液。女性和既往使用头孢菌素类(第二代或第三代)抗菌药物是ESBLs大肠埃希菌感染的危险因素。ESBLs大肠埃希菌对青霉素类、头孢菌素类和氨曲南的耐药率较高,对亚胺培南和阿米卡星较敏感。结论 ESBLs大肠埃希菌引起的感染常见为尿路感染,影响因素很多,常规的ESBLs检测及药敏试验分析有助于减少ESBLs传播及多重耐药菌株的产生,有效控制感染。Objective To investigate the distribution of extended spectyum β lactamase（ESBLs） enterobacteriaceae in Huai＇an Women ＆ Children Hospital, and to study drug resistance and risk factors of ESBLs in escherichia coli infections. Methods The distribution and drug sensitivity of 1 826 enterobacteriaceae bacteria isolated from clinical samples in January 2015 to December 2017 were analized. A case-control study was designed to identify risk factors for infections caused by ESBL- producing escherichia coli. Results Of the 1 826 isolated Enterobacteriaceae, 549 strains （30.1%） were ESBL-producing bacteria. Escherichia coli and klebsiella were the main ESBL-producing enterobacteriaceae. The most abundant source of ES- BLs escherichia coli was urine, then sputum.Risk factors for infections caused by ESBLs Escherichia coliwere female and pre vious receipt of oral cephalosporins.The ESBLs Escherichia coli isolates exhibited very high resistance rates to penicillins, cephalosporins and aztreonam, but they were susceptible to imipenem and amikacin. Conclusion The common infection clue to ESBLs escherichia coli is the urinary tract infection, and influenced by many factors. ESBL detection and analysis of antibi otic resistance may help reduce the spread of ESBLs and antibiotic resistance, so as to control infection efficiently.

关 键 词：β内酰胺抗药性 大肠杆菌 抗药性 微生物 危险因素 

分 类 号：R446.5[医药卫生—诊断学]