摘要
目的调查本院近3年来分离的大肠埃希菌临床分布及耐药现状,为临床合理用药提供一定的依据。方法对2009～2011年本院临床送检各类标本进行分离培养鉴定,采用K-B纸片扩散法检测其对抗菌药物的耐药性。结果共分离出大肠埃希菌1287株,主要分离自尿液标本,占47.3%,其次为痰液(31.9%)。临床分布以泌尿外科、内分泌科、呼吸内科和肿瘤科为主,共分离出产超广谱β-内酰胺酶(ESBLs)大肠埃希菌617株,阳性率为47.9%,对抗菌药物耐药率无显著上升趋势,但耐药性仍非常严重,产ESBLs菌株对所测试的氨苄西林,一、二代头孢菌素和部分三代头孢菌素及单环类抗菌药物耐药率为100.0%,对庆大霉素、环丙沙星、氨基糖苷类、喹诺酮类和磺胺类的耐药率均>70%,显著高于非产ESBLs菌株,未检出耐亚胺培南的大肠埃希菌。结论大肠埃希菌多重耐药严重,碳青霉烯类抗菌药物是治疗产ESBLs细菌引起严重感染的首选。临床应根据药敏结果制定合理的用药方案,加强消毒隔离措施,以控制和减少多重耐药菌株和产ESBLs菌株的产生与传播。
Objective To explore the clinical distribution and antimicrobial resistance status of Escherichia coli in our hospital in recent three years and to provide a theoretical basis for clinical use of antibiotics. Methods The clinical samples were collected from the patients from 2009 to 2011 in our hospital. The bacteria were isolated and cultured, while antimicrobial susceptibility detection was performed by Kirby-Bauer disk diffusion. Results Total of 1287 strains of Escherichia coli were isolated, among which which the urine samples and sputum accounted for 47.3% and 31.9% , respectively. E. coli was mainly distributed in the uropoiesis surgical department, endocrinology, internal medicine and oncology in this study. The average positive rate of 617 extended-spectrum β-1actamasaes （ESBLs）-producing strain was 47.9%. There was no significant increaseing trend in antimicrobial resistance rates, but the autimicrobial resistance was very serious. Antimicrobial resistance rates of ESBLs-produing strains were 100. 0% to ampicillin, first generation cephalosporin, second generation cephalosporin, part of third generation cephalosporin and monobactam antibiotic, which were all over 70.0% to gentamycin, ciprofloxacin and compound sulfamethoxazole and higher than that of non-produing ESBLs ones. No imipenem-resistant strain was found. Conclusions The multidrug resistance of Escherichia coli is a serious problem. The antibiotics should be applied in accordance with the results of antimicrobial susceptibility tests. The use of broad-spectrum antibiotics should be controlled strictly in order to decrease the generation and transmission of ESBLs-producing strains.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2013年第1期51-54,共4页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
关键词
大肠埃希菌
超广谱B一内酰胺酶
耐药性
Escherichia coli
Extended-spectrum β-laetamasaes
Antibiotic resistance
