2013-2017年老年病医院大肠埃希菌临床分布及耐药性分析  

Clinical distribution and antimicrobial resistance of Escherichia coli in a geriatric hospital from 2013 to 2017

作　　者：祝丙华[1] 林虎[1] 张蓉[1] 张金萍[1] 刘文清 ZHU Bing-hua;LIN Hu;ZHANG Rong;ZHANG Jin-ping;LIU Wen-qing(Hospital of PLA,Beijing 100017,China)

机构地区：[1]解放军第305医院医务部,北京100017 [2]解放军第960医院泰安院区,山东泰安271001

出　　处：《中华医院感染学杂志》2019年第15期2256-2260,共5页Chinese Journal of Nosocomiology

基　　金：国家重大传染病基金资助专项(2017ZX10303401);军队医学科技青年培育计划基金资助项目(19QNP113)

摘　　要：目的了解某老年病医院大肠埃希菌临床分布及耐药性变化趋势,为临床合理使用抗菌药物及有效控制医院感染提供依据。方法采用回顾性分析方法,对2013-2017年某医院住院患者分离的1 215株大肠埃希菌进行标本来源、科室分布、耐药性变化等分析,数据采用WHONET5.4和SPSS13.0软件进行分析。结果2013-2017年共分离细菌14 363株,其中大肠埃希菌1 215株,分离率8.46%,5年分离率呈逐年下降趋势(trendχ^2=41.705,P<0.001);标本来源主要为尿液,579株占47.65%;分离科室主要为呼吸内科235株占19.34%、神经内科189株占15.56%;药敏分析表明,对氨苄西林、氨苄西林/舒巴坦、左氧氟沙星耐药率>70%;对阿米卡星耐药率均<10%;对亚胺培南耐药率均<30%;对头孢吡肟、头孢替坦、头孢哌酮/舒巴坦耐药率较低,其他头孢类药物耐药率均在70%左右。结论该院大肠埃希菌分离率呈逐年下降趋势;分离菌主要来源于尿液,科室分布主要在神经内科、呼吸内科;对多种抗菌药物耐药率较高,应加强监测,根据药敏结果合理选用治疗药物。OBJECTIVE To analyze the clinical distribution and antimicrobial resistance of Escherichia coli from a geriatric hospital,so as to guide the rational use of antibiotics and to provide basis for the prevention and control of nosocomial infection.METHODS A retrospective analysis was carried out on 1 215 strains of E coli isolated from inpatients in a hospital from 2013 to 2017.The specimen sources,department distribution and changes in antimicrobial resistance were analyzed.The data were analyzed by using WHONET 5.4 and SPSS 13.0 software.RESULTS From 2013 to 2017,14363 strains of bacteria were isolated,including 1215 strains of E coli with the isolation rate of 8.46%(trendχ^2=41.705,P<0.001).The isolation rate showed a decreasing trend in the five years.The source of specimens was mainly urine(579 strains,accounting for 47.65%).The main departments were respiratory medicine(235 strains,accounting for 19.34%)and neurology department(189 strains,accounting for 15.56%).The resistance rates of E coli to ampicillin,ampicillin/sulbactam,levofloxacin were all above 70%;the resistance rate of E coli to amikacin was below 10%;the resistance rate of E coli to imipenem was below 30%;the resistance rates of E coli to cefepime,cefotetan,cefoperazone/sulbactam were relatively low,but the resistance rates of E coli to other cephalosporins were all around 70%.CONCLUSION The detection rate of E coli gradually decreased from 2013 to 2017.The bacteria were mainly isolated from urine specimens and the main departments were respiratory medicine and neurology department.The resistance rates of E coli to multiple kinds of antibiotics were high,so the rational use of antibiotics should be monitored and antibiotics should be selected according to the antimicrobial susceptibility test.

关 键 词：大肠埃希菌 临床分布 耐药性 

分 类 号：R446.5[医药卫生—诊断学]