2012—2021年我院大肠埃希菌临床样本分布及耐药性分析  

Analysis of clinical sample distribution and drug resistance of Escherichia coli in Yunnan Provincial Hospital of Infectious Disease from 2012 to 2021

作　　者：樊红丽 谢祺 张米 杨翠先 李正伦 高丽 FAN Hong-li;XIE Qi;ZHANG Mi;YANG Cui-xian;LI Zheng-lun;GAO Li(Department of Clinical Laboratory,AIDS Care Center Laboratory,Yunnan Provincial Hospital of Infectious Disease,Kunming 650301,Yunnan,CHINA)

机构地区：[1]云南省传染病医院/艾滋病关爱中心检验科,云南昆明650301

出　　处：《海南医学》2023年第1期82-87,共6页Hainan Medical Journal

基　　金：云南省感染性疾病(艾滋病)临床医学研究中心—云南省艾滋病病毒学及临床诊疗技术创新研究中心(编号:202102AA310005);云南省高层次卫生健康技术人才培养专项经费资助(编号:H-2018018)。

摘　　要：目的 探讨我院近10年来大肠埃希菌的临床样本分布及耐药性情况,为临床合理用药提供依据。方法 采用VITEK细菌鉴定及药敏分析仪对2012年1月至2021年12月期间云南省传染病医院临床送检的4 201份微生物样本进行细菌分离鉴定和药敏试验,同时检测超广谱β-内酰胺酶,并结合相关临床信息进行统计分析。结果 共检出大肠埃希菌757株,其中来自艾滋病患者595株占78.60%,来自非艾滋病患者162株占21.40%。样本类型以尿液为主占41.08%。在10年间,大肠埃希菌的检出率在12.85%至22.55%之间波动。10年内,产超广谱β内酰胺酶(ESBLs)的大肠埃希菌平均检出率为61.16%,检出率在51.95%至67.50%之间波动,总体趋于稳定。药敏结果显示:大肠埃希菌对氨苄西林耐药率>90%,对阿米卡星和三种碳青霉烯类的耐药率<5%,对呋喃妥因、哌拉西林/他唑巴坦耐药率<20%。产ESBLs的大肠埃希菌与非产ESBLs的大肠埃希菌相比,除阿米卡星、美罗培南、四环素、亚胺培南、呋喃妥因耐药性比较差异均无统计学意义(P>0.05)外,产ESBLs的大肠埃希菌对其余抗微生物药物耐药性比较差异均有统计学意义(P<0.05)。且产ESBLs的菌株对青霉素类中的氨苄西林和哌拉西林的耐药率为100%,对三代头孢菌素的耐药率均大于90%。结论 大肠埃希菌在我院10年间的检出率趋于稳定,产ESBLs的大肠埃希菌耐药形势严峻。Objective To explore the clinical sample distribution and drug resistance of Escherichia coli in Yunnan Provincial Hospital of Infectious Disease in recent 10 years, so as to provide basis for clinical rational drug use.Methods VITEK bacteria identification and drug sensitivity analyzer were used to conduct bacteria isolation identification and drug sensitivity test on 4 201 microbial samples submitted by Yunnan Provincial Hospital of Infectious Disease for clinical examination from January 2012 to December 2021. The ultra broad spectrum β-Lactamase was detected and statistically analyzed in combination with relevant clinical information. Results A total of 757 strains of Escherichia coli were detected, including 595 strains from AIDS patients, accounting for 78.60%, and 162 strains from patients without AIDS, accounting for 21.40%. The sample type is mainly urine, accounting for 41.08%. In 10 years, the detection rate of Escherichia coli fluctuated between 12.85% and 22.55%;the average detection rate of extended-spectrum β-lactamase(ESBLs)-producing Escherichia coli was 61.16%, and the detection rate fluctuated from 51.95% to 67.50%, which was generally stable. The drug sensitivity results showed that the drug resistance rate of Escherichia coli was more than 90%to ampicillin, less than 5% to amikacin and three carbapenems, and less than 20% to furantoin, piperacillin/tazobactam. Compared with non-ESBLs-producing Escherichia coli, ESBLs-producing Escherichia coli showed no statistically significant difference in the resistance to amikacin, meropenem, tetracycline, imipenem, and furantoin(P>0.05), but significant difference in the resistance to other antimicrobials(P<0.05). The resistance rate of ESBLs-producing strains to ampicillin and piperacillin was 100%, and the resistance rate to third-generation cephalosporins was more than 90%. Conclusion The detection rate of Escherichia coli in the hospital has been stable for 10 years, and the drug resistance of ESBLs-producing Escherichia coli is severe.

关 键 词：大肠埃希菌 耐药性 超广谱Β内酰胺酶 抗微生物药物 检出率 

分 类 号：R378.2[医药卫生—病原生物学]