摘要
目的:调查引起我院患者血流感染的大肠埃希菌的检出率及其耐药谱,为临床合理应用抗菌药物提供参考。方法:收集分离自我院2005年1月-2008年12月期间住院患者血培养标本的病原菌共923株,利用VITEK全自动微生物分析仪进行菌种鉴定,双纸片法确证试验检测超广谱β-内酰胺酶(ESBLs),纸片扩散反(K-B)法进行药敏试验。结果:引起血流感染的923株病原菌中,共检到大肠埃希菌175株,占18.96%,其中产ESBLs菌株92株(占52.6%,92/175)。产ESBLs大肠埃希菌对氨苄西林、头孢唑啉、头孢曲松、头孢他定的耐药率均超过80%,分别为98.9%、97.8%、94.6%和83.7%,明显高于非产ESBLs菌株;产ESBLs菌株对复方新诺明、环丙沙星、庆大霉素、妥布霉素和左氧氟沙星的耐药率均超过50%,分别为76.1%、57.6%、57.6%、58.7%和69.6%。产ESBLs大肠埃希菌与非产ESBLs大肠埃希菌对哌拉西林/他唑巴坦、呋喃妥因的耐药率均低于5%。本研究中所有大肠埃希菌对亚胺培南均敏感。结论:引起血流感染的大肠埃希菌的耐药现象严重,临床上需及时监测细菌的耐药性变迁,指导临床合理选择抗菌药物。
Objective： To investigate the drug resistance of escherichia coli isolated from patients with bloodstream infection to commonly used antibiotics, and to provide reference for clinical anti-infective drug therapy. Methods： The France Bio-Merieux company VITEK-60 compact automatic bactecial identification instrument was employed to identify the bactecia. According to the（NCCLS） 2005, the double disk confirmatory test were adopted to detect ESBLs, and K-B disk diffusion assay was used to determine antibiotic resistance of escherichia coli. Results： Totally 175 strains of escherichia coli were isolated from the samples, among them, ESBLs-producing strains accounted for 52.6%（92/175）. The drug resistence of ESBL-producing escherichia coli to ampicillin, cefazolin, ceftriaxone, ceftazidime were 98.9%, 97.8%, 94.6%, 83.7% respectively, which were significantly higher than that of non-ESBL-producing escherichia coli. The drug resistence of ESBL-producing escherichia coli to trimesulf, ciprofloxacin, gentamycin, tobramycin, levofloxacin were 76.1%, 57.6%, 57.6%, 58.7%, 69.6% respectively. The drug resistence rate to piperacillin tazobactam and macrodantin were almost similar in ESBL-producing escherichia coli and non-ESBL-producing escherichia coli. And the whole escherichia coli were sensitive to tienam and vancomycin. Conclusion： Escherichia coli as the major gram-negative bacterium led to bloodstream infection, its resistance phenomenon to common antibiotics was serious. It is necessary to pay more attention to the the drug resistance to provide reference for clinical anti-infective drug therapy.
出处
《温州医学院学报》
CAS
2014年第12期917-919,共3页
Journal of Wenzhou Medical College
关键词
血流感染
大肠埃希菌
耐药谱
抗菌药物
产ESBLs
bloodstrem infection
escherichia coli
drug resistence spectrum
anti-bacterial aget
extended spectrum beta-lactamases
