大肠埃希菌所致尿路感染药敏试验分析

Analysis of susceptibility test of Escherichia Coli in urinary tract infection

目的研究尿路感染中大肠埃希菌的耐药性变迁,为临床用药提供参考。方法对2004年和2005年检出的89份尿液标本中的大肠埃希菌,采用K-B法药敏试验,并进行超广谱β-内酰胺酶(ESBLs)检测。结果2004年和2005年大肠埃希菌的检出率分别为29.9%和32.3%,产酶率分别为39.5%和51.0%,呈增高趋势。大肠埃希菌对哌拉西林/他唑巴坦、亚胺培南、丁胺卡那霉素、头孢他啶、呋喃妥因和复方新诺明耐药率较低,分别为2.2%、3.3%、14.6%、23.6%、32.6%和38.2%,而其他常用抗生素的耐药率均大于50%,另外ESBLs(+)细菌的检出率有上升趋势,ES-BLs(+)细菌对头孢菌素的耐药率普遍高于ESBLs(-)细菌(P(0.01)。结论尿路感染中的大肠埃希菌检出率和产酶率不断升高,临床医生应当根据药敏试验来选择抗生素。

Objective To research the drug tolerance variation of Escherichia Coli in urinary tract infection,and to provide reference to clinical medication. Methods Eighty-nine Escherichia Coli infected urinary samples which were collected from 2004 to 2005 were carried out K-B method susceptibility test and ESBLs test. Results The detection rates of Escherichia Coli in 2004 and 2005 were 29.9% and 32.3 % respectively,and the production rates of enzyme were 39.5% and 51.0% respectively. Both showed an upward tendency. Escherichia Coli have a low drug tolerance rate for piperacillin/Tazobactam（2.2% ）, imipenem（3.3% ） ,butylamine（ 14.6% ） ,ceftazidime（23.6% ） ,nitrofurantoin（32.6% ） and cotrimoxazole（38.2% ）. As for other commonly used antibiotics,the rate was all over 50%. Also, ESBLs（ ＋ ） bacterium showed a upward detection rate and generally had a higher drug tolerance rate than ESBLs（ - ） bacterium（P 〈 0.01 ）. Conclusion With an increasing detection rate and enzyme-producing rate of Escherichia Coli in urinary tract infection, clinicians should choose antibiotics based on susceptibility test.