2016年8月至2020年8月承德医学院附属医院大肠埃希菌感染特点、耐药性及影响因素分析  

Analysis on Characteristics,Drug Resistance and Influencing Factors of Escherichia Coli Infection in the Affiliated Hospital of Chengde Medical College from Aug.2016 to Aug.2020

作　　者：闫妹姝[1] 明颖 陶晓明[1] 宗春光[1] YAN Meishu;MING Ying;TAO Xiaoming;ZONG Chunguang(Dept.of Clinical Laboratory,the Affiliated Hospital of Chengde Medical College,Hebei Chengde 067000,China)

机构地区：[1]承德医学院附属医院检验科,河北承德067000

出　　处：《中国医院用药评价与分析》2021年第1期105-108,共4页Evaluation and Analysis of Drug-use in Hospitals of China

基　　金：承德市科技计划项目(No.201606A034)。

摘　　要：目的:了解承德医学院附属医院大肠埃希菌的感染特点、耐药性,探讨与大肠埃希菌耐药性相关的影响因素。方法:对2016年8月至2020年8月承德医学院附属医院临床送检的各类标本进行细菌菌株鉴定,统计大肠埃希菌标本来源、科室分布及产超广谱β-内酰胺酶(extended spectrumβlactamase,ESBL)大肠埃希菌检出情况,并分析大肠埃希菌对常用抗菌药物的耐药性,对大肠埃希菌耐药率较高药物的耐药性影响因素进行分析。结果:共分离出389株大肠埃希菌,主要来源于尿液(188株,占48.33%);泌尿外科分离出的大肠埃希菌最多,共121株(占31.11%);2016年8月至2020年8月检出大肠埃希菌菌株数构成比呈逐渐升高趋势,产ESBL大肠埃希菌菌株数构成比也呈逐渐升高趋势;大肠埃希菌对氨苄西林的耐药率最高,2016年8—12月、2017、2018、2019和2020年1—8月的耐药率分别为77.59%(45/58)、77.61%(52/67)、79.27%(65/82)、79.31%(69/87)和81.05%(77/95),另外,大肠埃希菌对哌拉西林、头孢唑林的耐药率也较高;大肠埃希菌对氨苄西林的耐药性可能与患者存在应用其他抗菌药物时间≥15 d、产ESBL菌株有关。结论:2016年8月至2020年8月承德医学院附属医院大肠埃希菌在泌尿外科及尿液中的检出率较高,且具有较高的耐药性,在临床治疗中应根据药物敏感试验结果进行抗菌药物的选择,以避免抗菌药物滥用导致细菌耐药率升高。OBJECTIVE:To investigate the characteristics and drug resistance of Escherichia coli(E.coli)in the Affiliated Hospital of Chengde Medical College,and to analyze the influencing factors related to the drug resistance of E.coli.METHODS:Bacterial strain identification was conducted on various specimens submitted for clinical examination in the Affiliated Hospital of Chengde Medical College from Aug.2016 to Aug.2020,the source of E.coli,distribution of departments and detection of E.coli of extended spectrumβ-lactamase(ESBL)producing were collected,so as to analyze the drug resistance of E.coli to commonly used antibiotics and the factors affecting the resistance of drugs with high resistance rate of E.coli.RESULTS:Totally 389 strains of E.coli were isolated,mainly from urine(188 strains,48.33%);the mostly was from department of urinary surgery,totally 121 strains(31.11%);from Aug.2016 to Aug.2020,the composition ratio of the number of E.coli strains detected was gradually increasing,and the detection rate of E.coli of ESBL-producing also showed a gradually increasing trend;E.coli had the highest resistance to ampicillin,with the drug resistance rates were respectively 77.59%(45/58),77.61%(52/67),79.27%(65/82),79.31%(69/87)and 81.05%(77/95)on Aug.-Dec.2016,2017,2018,2019 and Jan.-Aug.2020.In addition,E.coli also had relatively high resistance to piperacillin and cefazolin;the resistance of E.coli to ampicillin may be related to the application of other antibiotics for≥15 days and ESBLproducing strains.CONCLUSIONS:From Aug.2016 to Aug.2020,the detection rate of E.coli in urology surgery department and urine in the Affiliated Hospital of Chengde Medical College is relatively high,which has high drug resistance.The selection of antibiotics for clinical treatment should be based on the results of drug sensitivity test,so as to avoid the increasing of bacterial resistance rate caused by the abuse of antibiotics.

关 键 词：大肠埃希菌 感染 耐药性 影响因素 

分 类 号：R978.1[医药卫生—药品]