2663株大肠埃希菌的临床分布及耐药性分析  

Clinical distribution and drug resistance of 2 663 Escherichia coli strains

作　　者：熊域皎 杨建科[2] 鲍永强[3] 陈科帆[1] 袁术生 XIONG Yujiao;YANG Jianke;BAO Yongqiang;CHEN Kefan;YUAN Shusheng(Department of Infection,Leshan People's Hospital,Leshan,Sichuan 614000,China;Department of Laboratory,Leshan People's Hospital,Leshan,Sichuan 614000,China;Department of Nephrology,Leshan People's Hospital,Leshan,Sichuan 614000,China)

机构地区：[1]乐山市人民医院感染科,四川省乐山市614000 [2]乐山市人民医院检验科,四川省乐山市614000 [3]乐山市人民医院肾内科,四川省乐山市614000

出　　处：《中南医学科学杂志》2022年第3期413-416,共4页Medical Science Journal of Central South China

基　　金：乐山市重点科技计划项目(17SZD229)。

摘　　要：目的 分析本院2017—2020年分离的2 663株大肠埃希菌的临床分布特点和耐药性。方法 常规分离培养细菌,采用最低抑菌浓度法进行药物敏感试验,用WHONET5.6和SPSS19.0软件进行数据统计分析。结果2 663株大肠埃希菌标本来源和科室分布以尿液(25.8%)及胃肠外科(23.8%)为主,产ESBL菌株总检出率42.9%。大肠埃希菌对氨苄西林的耐药率最高(83.4%),对头孢菌素类及喹若酮类抗菌药物耐药率均在40.0%左右,但对碳青霉烯类抗菌药物高度敏感,对头孢西丁及哌拉西林/他唑巴坦保持较高敏感性,且在4年间对检测的各种抗菌药物的耐药率变化不大。产ESBL大肠埃希菌耐药率高,对头孢曲松和头孢噻肟耐药率达100.0%,且对受试抗菌药物的耐药率明显高于非产ESBL菌株(P<0.05)。结论 本次大肠埃希菌的耐药监测中,产ESBL大肠埃希菌耐药率高,监测大肠埃希菌耐药性对指导临床合理应用抗菌药物并防止耐药菌株传播流行具有重要意义。Aim To analyze the clinical distribution characteristics and drug resistance of 2,663 Escherichia coli strains isolated in the hospital from 2017 to 2020. Methods The bacteria were isolated and cultured, and used for drug sensitivity test by minimal inhibitory concentration method. WHONET5.6 and SPSS 19.0 software were used for statistical analysis. Results Most of the 2,663 Escherichia coli strains were isolated from urine specimens(25.8%) and specimens from gastrointestinal surgery department(23.8%). The total detection rate of ESBL-producing strains was 42.9%. Escherichia coli was the most resistant to ampicillin, with a resistance rate of 83.4%. The resistance rates to cephalosporins and quinolones were about 40.0%, but it was highly sensitive to carbapenems. Meanwhile, it was highly sensitive to cefoxitin and piperacillin/tazobactam, and there were no significant changes in the resistance rates to antibacterial drugs tested in 4 years. The resistance rate of ESBL-producing Escherichia coli was high, and the resistance rates to ceftriaxone and cefotaxime reached 100.0%, in addition, its resistance rates to the tested antibacterial drugs were significantly higher than those of non-ESBL-producing strains(P<0.05). Conclusion This drug resistance monitoring of Escherichia coli shows that the resistance rate of ESBL-producing Escherichia coli is high. Monitoring the drug resistance of Escherichia coli can help guide clinical rational use of antimicrobial drugs, thereby preventing the spread of drug-resistant strains.

关 键 词：大肠埃希菌 超广谱Β-内酰胺酶 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]