结核病医院大肠埃希菌分布特征与耐药性变迁分析  

Analysis of clinical distribution and drug resistance changes of Escherichia coli in a tuberculosis hospital

作　　者：胡族琼[1] HU Zuqiong(Department of Clinical Laboratory,Guangzhou Chest Hospital,Guangzhou 510095,China)

机构地区：[1]广州市胸科医院检验科,广州510095

出　　处：《中国处方药》2025年第5期34-38,共5页Journal of China Prescription Drug

基　　金：广州市科技计划项目(2023A03J0539)。

摘　　要：目的分析2018年1月~2023年12月广州市胸科医院大肠埃希菌分布特征及耐药性变迁情况,为临床合理用药及感控工作提供依据。方法利用WHONET5.6和SPSS26.0软件对2018年1月~2023年12月广州市胸科医院分离鉴定的大肠埃希菌的标本来源、临床分布、对18种常用抗菌药物耐药率及产超广谱β-内酰胺酶(ESBLs)分离率进行统计分析。结果共分离到608株大肠埃希菌,来自下呼吸道标本占比最高,达49.51%,其次是尿液(23.68%)、脓液(8.72%)和血液(5.26%)。分离最多的前3个科室为ICU、耐多药结核病科和骨结核外科。608株大肠埃希菌对18种常用抗菌药物6年平均耐药率显示,对氨苄西林耐药率最高,达92.43%,其次是对头孢唑啉、左氧氟沙星及头孢曲松,耐药率都超过70.00%;对替加环素耐药率最低,仅1.32%,其次是厄他培南(5.26%)、亚胺培南(5.92%)。6年中,随着年份的递增,大肠埃希菌对氨苄西林/舒巴坦耐药率呈下降趋势,对头孢吡肟和头孢唑啉耐药率呈上升趋势,对其余各抗菌药物耐药率与年份变化无线性关系。6年间ESBLs阳性菌株检出率差异无统计学意义(P>0.05),但6年总检出率高达63.82%;除替加环素之外,ESBLs阳性菌株对其余各常用抗菌药物耐药率都显著高于ESBLs非阳性菌株(P<0.01)。结论该院大肠埃希菌主要来自病情严重科室,以感染下呼吸道为主,耐药性严重,ESBLs阳性菌株检出率高,临床应根据药敏结果合理选择抗菌药物,防止耐药菌产生。做好重点科室感染控制工作,防止耐药菌传播。Objective To analyze the clinical distribution and drug resistance changes ofEscherichiacoli(E.coli)isolated in Guangzhou chest hospital from January 2018 to December 2023 so as to provide reference for rational use of antimicrobial drugs and hospital infection control.Methods The source of specimens,clinical distribution,drug resistance rates to 18 commonly used antibacterial drugs and the detection rate of extended spectrumβlactamases(ESBLs)ofE.coliwhich were isolated in Guangzhou chest hospital from January 2018 to December 2023,were analyzed by the software of WHONET5.6 and SPSS26.0.Results A total of 608 strains ofE.coliwere isolated,mainly from lower respiratory tract specimens(301 strains,49.51%),then followed with urine(23.68%),pus(8.72%)and blood(5.26%).The top three clinical distributions were the department of intensive care units(ICU),the department of multidrug resistant tuberculosis and the orthopedic tuberculosis surgery.The 6-year average resistance rates of 608E.colistrains to 18 commonly used antimicrobial drugs were shown ampicillin was the highest(92.43%),then followed with cefazolin,levofloxacin and ceftriaxone,the average resistance rates were all higher than 70.0%;the lowest were to tigecycline(1.32%),then followed with ertapenem(5.26%)and imipenem(5.92%).During the past 6 years,with the increase of year,the resistance rate ofE.colito ampicillin/subactan decreased,and that to cefepime and cefazoline increased,and there was no linear relationship between the resistance rate to other antimicrobial drugs and the change of year.During the past 6 years,the detection rate of ESBLs positive strains had no significant difference(P>0.05),but its total detection rate was 63.82%;except for tigecycline,the drug resistance to other antimicrobial drugs of ESBLs positive strains was generally statistically higher than those of ESBLs negative strains(P<0.01).Conclusion Most ofE.coli strains in our hospital were isolated from clinical departments with severe illnesses and from lower respiratory tracts,furt

关 键 词：大肠埃希菌 耐药率 抗菌药物 临床分布 

分 类 号：R44[医药卫生—诊断学]