摘要
目的了解医院2008-2010年大肠埃希菌的分布及耐药性变化,指导临床用药。方法常规培养分离细菌,采用美国DADE BEHRING MicroScan分析系统鉴定菌种,K-B纸片法进行药敏试验。结果 982株大肠埃希菌标本来源中尿液566株占57.6%,痰液187株占19.0%,分泌物82株占8.5%;其科室主要分布在肾内科209株占21.3%,儿科118株占12.0%,普胸外科116株占11.8%;产ESBLs大肠埃希菌耐药率明显高于非产ESBLs大肠埃希菌(P<0.01),产ESBLs菌株主要分布在儿科、肾内科、泌外科;982株大肠埃希菌对青霉素类药物耐药率最高,余为喹诺酮类、头孢菌素类、单环内酰胺类、氨基糖苷类(除阿米卡星)以及磺胺类药物;对阿米卡星、头霉素类和β-内酰胺酶复合抑制剂(除氨苄西林/舒巴坦)的耐药率较低≤8.0%,对亚胺培南耐药率为0。结论大肠埃希菌ESBLs的检出率及其对绝大部分抗菌药物的耐药率维持在较高水平,治疗产ESBLs大肠埃希菌的感染首先选用酶抑制剂和头霉素类药物,并可联合阿米卡星,重症感染可选用碳青霉烯类药物。
OBJECTIVE To understand the distribution and drug resistance of Escherichia coli between 2008 and 2010 so as to guide the clinical use of antibiotics.METHODS The bacteria were isolated with the routine method,the species were identified with American DADE BEHRING MicroScan,the drug susceptibility testing was performed by K-B disc method.RESULTS Of 982 strains of E.coli isolated,there were 566（57.6%） strains isolated from urine,187（19.0%） isolated from the sputum,and 82（8.5%） strains from secretions.The isolates mainly distributed in the nephrology department（209 strains,21.3%）,118（12.0%） strains in the pediatrics department,and 116（11.8%） strains in general thoracic surgery department.The drug resistance rate of the ESBLs-producing E.coli was significantly higher than that of the non-ESBLs-producing E.coli（P0.01）,the ESBLs-producing strains mainly distributed in the pediatrics department,nephrology department,and urology department.The drug resistance rate of 982 strains of E.coli was the highest to penicillins,followed by quinolones,cephalosporins,monobactam,aminoglycosides（except amikacin）,and sulfa drug;the drug resistance rates to amikacin,cephamycins and beta-lactamase compound inhibitors（except ampicillin/sulbactam） were less than 8.0%,the drug resistance rate to imipenem was 0.CONCLUSION The detection rate of ESBLs-producing E.coli strains and their drug resistance to most antibiotics maintain a high level.The enzyme inhibitors and cephamycins can be selected as the first line drugs for the treatment of ESBL-producing E.coli infections,which can also be combined with amikacin,the severe infections can be treated with carbapenems.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第3期673-675,共3页
Chinese Journal of Nosocomiology
关键词
大肠埃希菌
分布
产超广谱Β-内酰胺酶
耐药率
Escherichia coli
Distribution
Extended spectrum betaqactamase
Drug resistance rate
