泌尿系疾病患者感染标本中大肠杆菌耐药性的检测

Prevalence of antimicrobial resistance of Escherichia coli isolated from specimens of patients with urinary diseases

目的监测泌尿系疾病患者感染标本中大肠杆菌耐药状况,为临床用药提供参考。方法回顾性分析2003年1-12月泌尿外科住院患者感染标本中分离的32株大肠杆菌对常用抗生素耐药性的检测结果,其中,菌株来自尿液20株、分泌物4株、脓液4株、引流液2株、血液和精液各1株。结果临床常用的22种抗生素中,耐药率>50%者10种,占45%。四环素的敏感率为0,氨苄西林、哌拉西林和萘啶酸的敏感率<10%。敏感率>80%者为阿米卡星、亚胺培南、头孢他啶、呋喃妥因、头孢哌酮、头孢吡肟共6种,未发现亚胺培南耐药菌株。结论泌尿系统感染致病菌中大肠杆菌的耐药性严重,其中以应用历史长、范围广的口服类抗生素的耐药性最为严重。

Objective To assess the prevalence of antibiotic resistance of Escherichia Coli isolated from specimens of patients with urinary diseases and to provide data on directing clinical therapy with medication. Methods A retrospective analysis of data of antibiotic sensitivity tests of 32 isolates from specimens of patients hospitalized in urological wards was performed at Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology in Wuhan from January through December 2003. Susceptibility to 22 antibiotics was determined using the disc diffusion method. Of the 32 isolates ,20 were obtained from urine,4 from secretions,4 from abscess,2 from drainage,1 from blood and 1 from sperm. Results Among the 22 antibiotics widely used in clinical practice, there were l0 （45%） with the resistance prevalence over 50%. Tetracycillin had the lowest sensitivity （0%）;and ampicillin, piperactcillin and nalidxic acid had their sensitivities less than 10%. The sensitivity rates of amikacin, ceftazidin, nitrofurantoin, cefoperazone, cefotacin were over 80%. No resistant isolate to imipenem was found. Conclusions These data suggest that the prevalence of antimicrobial resistance amongst Escherichia coli isolates from the specimens of patients with urinary diseases is severe. Oral antibiotics that have been widely used in a long history tend to have the highest antibiotic resistance.