松江区大肠埃希菌耐药性以及分布特点分析  

Analysis of Escherichia coli Drug Resistance and Distribution Characteristics in Songjiang District

作　　者：黄路遥[1] 王艺翔 刘军[1] 彭敬红[1] HUANG Lu-yao;WANG Yi-xiang;LIU Jun(Shanghai Songjiang District Central Hospital, Shanghai 201600)

机构地区：[1]上海市松江区中心医院检验科,上海201600

出　　处：《医学检验与临床》2019年第6期25-29,24,共6页Medical Laboratory Science and Clinics

摘　　要：目的:了解松江区大肠埃希菌的耐药情况以及在临床各科室和标本类型的分布情况,为临床治疗提供理论依据.方法:收集松江区中心医院2015年1月~2017年12月检出的965株大肠埃希菌,分析其在临床各科室和标本类型的分布特点和药敏结果.结果: 965株大肠埃希菌中,产ESBLs大肠埃希菌为548株,检出率为56.8%;本院大肠埃希菌主要分布于门诊、干部科、内分泌科、泌尿科和妇科;标本类型主要为尿液、生殖道标本、血液和呼吸道标本;产ESBLs大肠埃希菌对氨苄西林、头孢唑林、头孢曲松的耐药性在95%以上,对氨苄西林/舒巴坦、氨曲南、环丙沙星、左旋氧氟沙星、复方新诺明的耐药性在50%以上,对庆大霉素、头孢他啶、头孢吡肟、妥布霉素的耐药率在19.0%~41.6%之间,对哌拉西林/他唑巴坦、头孢替坦、阿卡米星、呋喃妥因的耐药性在5%以下,未发现厄他培南、亚胺培南耐药菌株;不同科室以及不同标本来源的大肠埃希菌株耐药性不同.结论:产ESBLs大肠埃希菌对临床大部分抗菌药物的耐药性高于ESBLs阴性大肠埃希菌,不同科室以及标本来源的大肠埃希菌产ESBLs率不同且耐药性也不同.Objective: To understand the drug resistance and distribution of Escherichia coli in Songjiang District among various departments and specimens, and to provide the theoretical basis for clinical treatment, we carried out this study. Methods: 965 Escherichia coli strains detected in Songjiang District Central Hospital from January 2015 to December 2017 were enrolled in this study and their distribution characteristics and drug susceptibility results in different clinical departments and specimen types were analyzed. Results:Among the 965 strains of Escherichia coli, 548 strains were ESBL-producing Escherichia coli. The detection rate was 56.8%. Escherichia coli in this hospital was mainly distributed in outpatient, cadre department, endocrinology department, urology department and gynecology department, mostly were urine, genital tract, blood and respiratory specimens. ESBL-producing Escherichia coli showed higher resistant rates to ampicillin, cefazolin, and ceftriaxone ( more than 95% ) . To ampicillin/sulbactam, aztreonam, ciprofloxacin, levofloxacin and compound sulfamethoxazole the drug resistance were all above 50% , and the resistant rates to gentamicin, ceftazidime, cefepime and tobramycin were 19.0~41.6%. The resistance to piperacillin/tazobactam, cefotetan, acarbamicin, and nitrofurantoin were less than 5%, no ertapenem, imipenem resistant strains were found. Escherichia coli strains from different departments and specimens showed different drug resistance. Conclusion: ESBL-producing Escherichia coli were more resistant to most clinical antibiotics than ESBL-negative Escherichia coli, and showed various detection and resistant rates in different departments and specimens.

关 键 词：大肠埃希菌 耐药性 ESBLS 

分 类 号：R181.34[医药卫生—流行病学]