摘要
目的:探讨并分析产超广谱β-内酰胺酶(ESBLs)大肠埃希菌的耐药性及影响产ESBLs大肠埃希菌所致血流感染患者预后的因素。方法:选择聊城市第二人民医院收治的253例大肠埃希菌所致血流感染患者作为研究对象。对这些患者均进行血培养,观察其血液中大肠埃希菌的检出情况,总结产ESBLs大肠埃希菌的耐药性,观察其中产ESBLs大肠埃希菌所致血流感染患者的预后,并分析影响其预后的因素。结果:对这253例患者进行血培养共培养出253株大肠埃希菌,其中产ESBLs的大肠埃希菌有120株(占47.43%)。产ESBLs的大肠埃希菌对氨苄西林、氨苄西林钠舒巴坦钠、头孢唑啉、头孢呋辛、头孢他啶、头孢曲松、氨曲南、环丙沙星、左旋氧氟沙星和复方新诺明均有较高的耐药性,其对头孢哌酮钠舒巴坦钠、哌拉西林钠他唑巴坦钠、头孢替坦、厄他培南、亚胺培南和美洛培南的耐药性较低。通过进行多因素logistic回归分析可知,进行有创机械通气和深静脉置管是影响产ESBLs大肠埃希菌所致血流感染患者预后的危险因素。结论:产ESBLs的大肠埃希菌对氨苄西林、氨苄西林钠舒巴坦钠、头孢唑啉等抗生素均有较高的耐药性,影响产ESBLs大肠埃希菌所致血流感染患者预后的危险因素主要是其进行有创机械通气和深静脉置管。
Objective:To investigate and analyze the drug resistance of Escherichia coli producing extended spectrumβ-lactamase(ESBLs)and the factors affecting the prognosis of patients with bloodstream infection caused by ESBLs producing Escherichia coli.Methods:A total of 253 patients with blood stream infection caused by Escherichia coli were selected as the research object.Blood culture was performed on all these patients to observe the detection of Escherichia coli in their blood,to summarize the resistance of ESBL-producing Escherichia coli,to observe the prognosis of the patients with bloodstream infection caused by ESBL-producing Escherichia coli,and to analyze the factors affecting the prognosis.Results:A total of 253 strains of Escherichia coli were obtained from the blood culture of the 253 patients,of which 120 strains(47.43%)were ESBLS-producing Escherichia coli.Producing ESBLs of e.coli to ampicillin sodium,ampicillin sodium shu ba,cefazolin,cefuroxime,he totally,ceftriaxone,ammonia QuNa cephalosporin,ciprofloxacin,ofloxacin and compound new Ming have higher resistance,the sodium cefoperazone sodium shu ba,piperacillin sodium he azole,cefotetan sodium,ertapenem and imide south culture and law culture of resistance is low.Multivariate logistic regression analysis showed that invasive mechanical ventilation and deep venous catheterization were risk factors for the prognosis of patients with ESBLS-producing bloodstream infection caused by E.coli.CONCLUSIONS:Escherichia coli producing ESBLs have high resistance to antibiotics such as ampicillin,ampicillin sodium sulbactam sodium,cefazoline,etc.The risk factors affecting the prognosis of patients with bloodstream infection caused by ESBLs producing Escherichia coli are mainly invasive mechanical ventilation and deep vein catheterization.
作者
田金静
路秀芳
刘诺凡
TIAN Jinjing;LU Xiufang;LIU Nuofan(The Second People’s Hospital of Liaocheng,Liaocheng 252600)
关键词
超广谱Β-内酰胺酶
大肠埃希菌
耐药性
血流感染
预后
影响因素
ultra-broad spectrumβ-lactamase
E.coli
Drug resistance
Bloodstream infection
The prognosis
Factors affecting the
