院外感染大肠埃希菌对10种抗菌药物的敏感性

Sensitivity of Escherichia coli as Pathogen of Out-hospital Infections to 10 Antimicrobials: Clinical Features of the Infection

目的 对大肠埃希菌所致院外感染的临床状况和该菌对 10种抗菌药物的敏感性进行观察和分析。方法 菌株来自临床分离的送检标本 ,进行细菌药敏试验检查大肠埃希菌对 10种抗菌药物的敏感性并进行临床状况调查 ,属院外感染者进入本研究 ,对敏感率差异进行χ2 检验。结果 共有 14 8例患者入选 ,感染部位以泌尿生殖系统为最多 ,平均住院时间为 2 1d,明显长于同期其他患者的平均住院时间 (17d) ;敏感率最高的药物是亚胺培南 /西司他丁 ,全部菌株对该药均敏感 ,无耐药菌株发现 ;耐药率最高的是环丙沙星 ,接近 70 % ;头孢他啶和阿米卡星、氨曲南和头孢吡肟、庆大霉素和头孢呋辛、环丙沙星和左氧氟沙星、环丙沙星和哌拉西林之间的敏感率差异无显著的统计学意义 ,其他各药物间敏感率差异显著 (P<0 .0 1) ;患者临床首次使用的抗菌药物出现频率由高到低依次为头孢呋辛、头孢曲松、左氧氟沙星、亚胺培南 /西司他丁、哌拉西林、阿米卡星。结论 院外感染的大肠埃希菌对环丙沙星、哌拉西林、左氧氟沙星和庆大霉素明显耐药 ,对亚胺培南 /西司他丁、阿米卡星和头孢他啶等敏感 ,临床首次选用的抗菌药物并非敏感率高的品种。

OBJECTIVE To investigate the sensitivity to 10 antibiotics of Escherichia coli causing out-hospital infections and the clinical feature of the infection. METHODS E. coli were detected from clinical isolates. The sensitivity of E. coli to the 10 antibiotics was measured. Clinical investigation was done to all the cases included. Cases infected outside the hospital were excluded from the study. The difference of sensitivity rate was analyzed with Chi square test. RESULTS All the 148 cases were included in the study. The most common site of infection was urogenital system. Mean hospitalization time was 21 days and markedly longer than that of other patients (17 d). The highest sensitive drug was imipenem, to which all of the strains were sensitive and no resistant strain was found. The resistant rate of ciprofloxacin was the highest, reaching up to approximately 70%. The frequency order of drugs being prescribed first from high to low was as follows: cefuroxime, levofloxacin, imipenem, piperacillin and amikacin. CONCLUSIONS E. coli infected outside hospital is resistant to ciprofloxacin, piperacillin, levofloxacin, and gentamicin; and sensitive to imipenem, amikacin, and ceftazidime. The antibiotics prescribed first clinically are not always the sensitive ones.