摘要
目的：探讨尿路感染大肠埃希菌不同遗传种系分型与耐药性的相关性。方法选取我院2013年1月至2014年3月分离的122株入院后48 h 内尿路感染大肠埃希菌与108株入院后48 h后尿路感染大肠埃希菌作为临床研究对象,所有样本均选自尿路感染患者的中段尿,其中患者入院后48 h 内分离到的尿路感染大肠埃希菌归为社区感染菌,患者入院后48 h 后分离到的尿路感染大肠埃希菌归为医院感染菌,采用 API20E 肠杆菌科细菌鉴定试剂盒与梅里埃公司 ATB 微生物半自动分析仪鉴定菌株,用制片扩散法测定尿路感染大肠埃希菌的药物敏感性,对比不同遗传种系分型尿路感染大肠埃希菌耐药性、产超广谱β-内酰胺酶（extended spectrum β-lactamases,ESBLs）率以及在医院感染与社区感染中的分布情况。结果根据试验结果可知,社区感染菌中与医院感染菌中均为 D 型比例最高,社区感染菌与医院感染菌的各遗传种系分型间无统计学差异（P 〉0.05）；230株大肠埃希菌中,共检出产酶菌株138株,单产 ESBLs76株,单产 AmpC 酶34株,同时检出 ESBLs 和 AmpC 酶28株。230株大肠埃希菌对抗生素的耐药性为：对临床常用抗生素耐药性从高到低依次为：复方新诺明81.7%、哌拉西林76.7%、氨苄西林74.2%、氨苄西林舒巴坦61.7%、丁胺卡那霉素61.7%、头孢呋辛60.8%、头孢泊肟59.2%、氨曲南59.2%、哌拉新林他巴唑32.5%、头孢唑林68.3%、庆大霉素57.5%、头孢噻肟43.3%、头孢吡肟38.3%、头孢西丁33.3%、亚胺培南0.8%。单产头孢菌素酶（AmpC 酶）、ESBLs 及同时产 ESBLs 和 AmpC 酶的大肠埃希菌对除亚胺培南外的14种抗生素的耐药率均高于平均水平。结论医院感染大肠埃希菌 D 型与社区感染大肠埃希菌 B1型的产 ESBLs 率最高,大肠杆菌 D 型对大部分抗菌药物高度耐药。
Objective To investigate different E.coli urinary tract infection germ line genetic typing and drug resistance of relevance.Methods Select our hospital between January 2013 and March 2014 separation of 122 strains within 48 h after admission e.coli urinary tract infection and 108 strains after 48 h after admission urinary tract infection e.coli as a clinical research objects,all samples are selected from mid-stream specimen of urine,urinary tract infection patients with isolated within 48 h after admission in patients with urinary tract infection e.coli as a community infected bacteria,isola-ted after 48 h after admission in patients with urinary tract infection e.coli bacteria for hospital infec-tion,mining API20E enterobacteriaceae bacteria identification kit with the French company ATB mi-crobial identification of strains,semi-automatic analyzer with producer diffusion method determination of urinary tract infection of e.coli drug sensitivity,contrast different genetic types of tie points urina-ry tract infections e.coli resistance,produce broad-spectrum beta lactamase（extended spectrum beta lactamases,ESBLs ） rate and the distribution of infection in hospital and community infection. Results Among the 230 strains of Escherichia coli,138 strains of producing strains were detected, and 34 strains of ESBLs and AmpC were detected by ESBLs76 and AmpC.230 strains of Escherichia＆nbsp;coli to antibiotics resistance：resistance to commonly used antibiotics in clinic from top to bottom in turn：cotrimoxazole 81 .7%,piperacillin,pull Westwood 76.7%,74.2% of ampicillin,ampicillin sul-bactam 61 .7%,butylamine card that mildew element 61 .7%,cefuroxime 60.8%,cephalosporins cef-podoxime 59.2%,ammonia aztreonam 59.2%,pethidine pull Xin Lin He cling to Zun 32.5%,cefazolin 68.3%,gentamicin 57.5%,cephalosporins cefotaxime 43.3%,cefotaxime cefepime 38.3%, cefotaxime and 33.3% of cefoxitin,imipenem 0.8%.①According to the test results,and no bacterial infection in the community and hospital infection bacteria are among the highest proportion of D-type germ line genetic typing of community-acquired bacterial infections and hospital bacteria statistically significant difference（P 〉0.05）;②Yield of AmpC,ESBLs and simultaneously producing ESBLs and AmpC enzyme in Escherichia coli antibiotic resistance rates of 14 except imipenem above average.Conclusions Hospital infection with Escherichia coli D-type ESBLs producing Escherichia coli infection in the community of the highest rates of B1-type,D-type E.coli to most highly resistant to antimicrobial drugs.
出处
《临床肾脏病杂志》
2015年第9期560-563,共4页
Journal Of Clinical Nephrology
关键词
尿路感染
大肠埃希菌
耐药性
Urinary tract infeetion
Escherichia coli
Drug resistance
