泌尿道感染大肠埃希菌耐药性及其产超广谱β-内酰胺酶检测

Detection of infection with extended spectrum β-lactamases-producing Escherichia coli in urinary tract and drug-resistance analysis

目的分析泌尿道感染的大肠埃希菌对常用抗菌药物的耐药情况及其产超广谱β-内酰胺酶(ESBLs)菌株的耐药特征,指导临床用药。方法采用VITEK-32系统、GNI+卡、GNS-120卡对分离菌进行菌种鉴定、ES-BLs检测和药敏试验。结果124株泌尿道感染大肠埃希菌产ESBLs株检出率为29.03%;产ESBLs菌对多种抗菌药物的耐药率明显高于非产ESBLs菌,其对β-内酰胺类药物100%耐药,对喹诺酮类、氨基糖苷类、磺胺类药物耐药性高,对头孢替坦、哌拉西林/他唑巴坦、呋喃妥因和阿米卡星的耐药率分别为16.67%,19.44%,22.22%和27.78%;所有受试菌对亚胺培南均敏感。结论泌尿道感染大肠埃希菌耐药性日益严重,要重视ESBLs的检测,治疗时应根据药敏结果选择抗菌药物。

Objective To analyze the drug resistance and detection of ESBLs-producing Escherichia coli in urinary tract and provide the reference for clinical antimicrobial usage. Methods Antimicrobial susceptibility tests and ESBLs-producing strains were detected with Vitek-32, GNI^＋, and GNS-120. Results The detection rate of ESBLs-producing strain among 124 strains of Escherichia coli was 29. 03%. The antimicrobial resistance rate of ESBLs-producing strains to many antimicrobial agents were much higher than that of non-ESBLs-producing strains. The resistance rate of ESBLs-producing strains to β-lactam antimicrobial agents was 100%, and resistant rates to quinolones, aminoglycosides and sulfonamides were all very high. The resistance rates to cefotetan, piperacillin/ tazobactam, nitrofurantoin and amikacin was 16. 67%, 19. 44%, 22. 22% and 27. 78% respectively, all strains were susceptible to imipenem. Conclusion Drag resistance of Escherichia coli in urinary tract infection become more and more serious, clinical treatment should choose antimicrobial agents according to antimicrobial susceptibility tests and ESBLs detection.