我院2016年临床分离大肠埃希菌耐药表型调查分析  

Investigation analysis of drug-resistant phenotypes of Escherichia coli clinically isolated from our hospital in 2016

作　　者：江素香 郑港森[2] 练明建 陈美珺[1] JIANG Su-xiang;ZHENG Gang-sen;LIAN Ming-jian;CHEN Mei-jun(Department of Laboratory,Zhongshan Hospital Affiliated to Xiamen University,Fujian Province,Xiamen 361004,China;Department of Laboratory,the First Affiliated Hospital of Xiamen University,Fujian Province,Xiamen,361003,China)

机构地区：[1]厦门大学附属中山医院检验科,福建厦门361004 [2]厦门大学附属第一医院检验科,福建厦门361003

出　　处：《中国当代医药》2020年第12期147-150,167,共5页China Modern Medicine

基　　金：福建省厦门市科技局基金资助项目(3502Z20154015)。

摘　　要：目的分析临床分离大肠埃希菌的耐药表型分布,为临床医生提供实验室数据以更好地指导抗生素治疗。方法回顾性分析2016年1~12月厦门大学附属第一医院临床分离的851株大肠埃希菌,采用法国BioMerieux VITEK2 Compact全自动细菌鉴定及药敏分析系统对菌株进行细菌鉴定和药物敏感性检测。结果2016年临床分离的大肠埃希菌851株,主要包括尿液425株,占49.9%;全血157株,占18.4%;无菌体液(包括胆汁、腹腔积液、胸腔积液、关节液不包括脑脊液)132株,占15.5%;痰液50株,占5.9%。四环素类抗生素(四环素和替加环素)共有4种耐药表型,以四环素(R/I)替加环素(S)为主;喹诺酮类抗生素(环丙沙星和左氧氟沙星)共有4种耐药表型,环丙沙星(R/I)左氧氟沙星(R/I)和环丙沙星(S)左氧氟沙星(S)为主;氨基糖苷类抗生素(庆大霉素、妥布霉素和阿米卡星)共有6种耐药表型,庆大霉素(S)妥布霉素(S)阿米卡星(S)和庆大霉素(R/I)妥布霉素(R/I)阿米卡星(S)耐药表型为主;β-内酰胺酶抑制剂复合物(阿莫西林/克拉维酸、氨苄西林/舒巴坦和哌拉西林/他唑巴坦)共有5种耐药表型,主要是阿莫西林/克拉维酸(S)氨苄西林/舒巴坦(R/I)哌拉西林/他唑巴坦(S)耐药表型;β-内酰胺类抗生素(氨苄西林、头孢呋辛、头孢噻肟、头孢他啶、头孢吡肟、氨曲南、亚胺培南和美罗培南)共有11种耐药表型,以氨苄西林(R/I)头孢呋辛(S)头孢噻肟(S)头孢他啶(S)头孢吡肟(S)氨曲南(S)亚胺培南(S)美罗培南(S)和氨苄西林(R/I)头孢呋辛(R/I)头孢噻肟(R/I)头孢他啶(S)头孢吡肟(S)氨曲南(S)亚胺培南(S)美罗培南(S)为主。不同标本的耐药表型分布存在一定的差别,但主要的耐药表型分布基本一致,大肠埃希菌对四环素、喹诺酮类和氨基糖胺类抗生素的耐药率超过或接近50%,但对替加环素、亚胺培南和美罗培南保持极高的敏感性。结论大肠埃希菌主要引起尿路感�Objective To analyze the distribution of drug-resistance phenotypes of clinically isolated Escherichia coli,and to provide clinicians with laboratory data to better guide antibiotic therapy.Methods The clinical isolates of 851 Escherichia coli in the First Affiliated Hospital of Xiamen University from January to December 2016 were retrospectively analyzed.Strain identification and drug sensitivity test were conducted by BioMerieux VITEK2 Compact automatic bacterial identification and drug sensitivity analysis system.Results A total of 851 strains of Escherichia coli were clinically isolated in 2016,mainly including 425(49.9%)strains from urine,157(18.4%)strains from whole blood,132(15.5%)sterile strains from body fluid(including bile,ascites,pleural effusion,joint fluid but not cerebrospinal fluid),and 50(5.9%)strains from sputum.There were four drug-resistant phenotypes of Tetracycline antibiotics(Tetracycline and Tegacycline),among which Tetracycline(R/I)Tegacycline(S)was the dominant phenotype.There were four drug-resistant phenotypes of Quinolone antibiotics(Ciprofloxacin and Levofloxacin)and two major phenotypes were Ciprofloxacin(R/I)Levofloxacin(R/I)and Ciprofloxacin(S)Levofloxacin(S).There were six drug-resistant phenotypes of aminoglycoside antibiotics(Gentamycin,Tobramycin and Amikacin)and two major phenotypes were Gentamycin(S)Tobramycin(S)Amikacin(S)and Gentamycin(R/I)Tobramycin(R/I)Amikacin(S).There were five drug-resistant phenotypes ofβ-lactam enzyme inhibitor complexes(Amoxicillin/Clavulanic Acid,Ampicillin/Sulbactam and Piperacillin/Tazobatam)and Amoxicillin/Clavulanic Acid(S)Ampicillin/Sulbactam(R/I)Piperacillin/Tazobattan(S)was the dominant phenotype.There were eleven drug-resistant phenotypes ofβ-lactam antibiotics(Ampicillin,Cefuroxime,Ceftaxime,Ceftadime,Cefepime,Aztreonam,Imipenem and Meropenem)and two major phenotypes were Ampicillin(R/I)Cefuroxime(S)Ceftaxime(S)Ceftadime(S)Cefepime(S)Aztreonam(S)Imipenem(S)Meropenem(S)and Ampicillin(R/I)Cefuroxime(R/I)Ceftaxime(R/I)Ceftadime(S)Cefepime(

关 键 词：大肠埃希菌 耐药 表型 抗生素 

分 类 号：R446.5[医药卫生—诊断学]