摘要
目的 描述产超广谱β-内酰胺酶大肠埃希菌(ultraspectrum β-lactamase Escherichia coli,ESBL-EC)的感染患者信息、临床分布等特征,分析ESBL-EC耐药情况,为医院感染防控提供依据。方法 选取2017—2022年厦门市第三医院住院患者中确诊为ESBL-EC感染的病例,收集患者及ESBLEC菌株信息,分析其感染情况、临床特征及耐药性。结果 共确诊ESBL-EC感染患者929例,社区感染与医院感染的性别、年龄比较,差异有统计学意义(P<0.001)。ESBL-EC检出率为38.52%,检出率呈逐年上升趋势(P <0.001)。ESBLEC主要来源于普外科(19.38%)。ESBL-EC主要分离自尿液(43.38%)。ESBL-EC对氨曲南、呋喃妥因、复方新诺明、头孢唑林、头孢吡肟、妥布霉素6种抗菌药物,耐药率整体呈下降趋势,差异有统计学意义(P<0.05);对环丙沙星、头孢他啶、庆大霉素3种抗菌药物的耐药率呈上升趋势,差异有统计学意义(P<0.05)。医院感染ESBL-EC对氨苄西林、氨苄西林/舒巴坦、呋喃妥因、环丙沙星、庆大霉素、头孢菌素、妥布霉素、左氧氟沙星的耐药率均高于社区感染,差异有统计学意义(P<0.05)。结论 ESBL-EC检出率呈逐年增高的趋势。ESBL-EC耐药形势较为严峻,应加强各项感染防控措施,降低交叉感染风险;合理使用抗菌药物,减少ESBL-EC耐药菌株产生。
Objective To describe the information and clinical distribution of ultra-broad spectrumβ-lactamase Escherichiacoli(ESBL-EC),analyze the resistance of ESBL-EC,and provide a basis for the prevention and control of nosocomial infection.Methods Patients diagnosed with ESBL-EC infection in the Third Hospital of Xiamen from 2017 to 2022 were selected to collect the information of patients and ESBL-EC strains,and analyze their infection status,clinical characteristics and drug resistance.Results A total of 929 patients with ESBL-EC infection were diagnosed,and the gender and age differences between community infection and hospital infection were statistically significant(P<0.001).The detection rate of ESBL-EC was 38.52%,and the detection rate showed an increasing trend year by year(P<0.001).The ESBL-EC was mainly derived from the general surgery department(19.38%).The ESBL-EC was mainly isolated from urine(43.38%).In ESBL-EC against aztreonam,nitrofurantoin,cotrimoxazole,cefepime,and tobramycin,the resistance rate decreased,the difference was statistically significant(P<0.05).The resistance rate to ciprofloxacin,ceftazidime and gentamicin showed an increasing trend,and the difference was statistically significant(P<0.05).The resistance rate of ESBL-EC to ampicillin,ampicillin/sulbactam,nitrofurantoin,ciprofloxacin,gentamicin,cephalosporin,tobramycin,and levofloxacin were higher than those of the community infection,the difference was statistically significant(P<0.05).Conclusion The detection rate of ESBL-EC has increased year by year.The resistance situation of ESBL-EC resistance is severe,and various infection prevention and control measures should be strengthened to reduce the risk of cross-infection;antimicrobial drugs should be rationally used reasonably to reduce the production of ESBL-EC resistant strains.
作者
陈江慧
蔡素因
秦维霞
王美婷
吕静丹
沈荣华
CHEN Jianghui;CAI Suyin;QIN Weixia;WANG Meiting;LYU Jingdan;SHEN Ronghua(Department of Hospital Infection Management,the Third Hospital of Xiamen/the First Affiliated Hospital of Xiamen University(Tong'an Branch),Xiamen Fujian 361102,China;Xiamen Hospital Infection Management Quality Control Center,Xiamen Fujian 361003,China;Department of Hospital Infection Management,the First Affiliated Hospital of Xiamen University,Xiamen Fujian 361003,China)
出处
《中国卫生标准管理》
2024年第10期170-176,共7页
China Health Standard Management
关键词
产超广谱Β-内酰胺酶大肠埃希菌
社区感染
医院感染
临床分布
耐药性
检出率
ultra-spectrumβ-lactamase Escherichia coli
community infection
hospital infection
clinical distribution
drug resistance
detection rate
