泌尿系感染大肠埃希菌的耐药性分析

Analysis of drug resistance for Escherichia coli during urinary tract infection

目的了解泌尿系感染的大肠埃希菌对常用抗生素的耐药情况,指导临床合理使用抗生素。方法应用WHONET5对2005～2006年本院肾内科分离的大肠埃希菌128株的药敏结果进行统计分析。结果128株大肠埃希菌中产超广谱β-内酰胺酶(ESBLs)占29.7%(38株),对氨苄西林、哌拉西林、头孢唑林、头孢呋辛、头孢曲松、复方新诺明、头孢噻肟、环丙沙星耐药率在76.3%～100.0%,其他被监测抗生素耐药率在50.0%以下;不产ES-BLs的占70.3%(90株),除氨苄西林、哌拉西林、复方新诺明、庆大霉素的耐药率达到50.0%以上,其他被监测抗生素耐药率均在50.0%以下。结论大肠杆菌产与不产ESBLs菌株对抗生素的耐药率存在差异;对于产ESBLs菌株临床可选用碳青霉烯类、氨基苷类和呋喃类;不产ESBLs菌株临床可选用头孢菌素类、硝基呋喃类、氟喹诺酮类抗生素。

Objective To understand Escherichia coil （E. coil） drug resistance to commonly used antimicrobial agents during urinary tract infection, and to guide the rational use of antibiotics. Methods 128 strains of E. coil were isolated from the Department of Nephrology in our hospital between the year 2005 to 2006 and the detection results were analyzed by WHONETS. Results In detected 128 strains of E. coli, extended spectrum β lactamases （ESBLs）producing E. eoli accounted for 29.7% （38/128）, and its rate of resistance to ampieillin, piperaeillin, eephazolin, cefuroxime, eefuroxime, TMP-SMZ, eefotaxime as well as eiprofloxaein was from 76.3% to 100.0%, and to the other monitoried antibiotics was below 50. 0%. By comparison, ESBLs non-producing E. eoli accounted for 70. 3% （90/128）, and its rate of resistance to most monitoried antibiotics was below 50.0% except that to ampieillin, piperaeillin, TMP-SMZ and gentamyein were above 50.0%. Conclusion There exists significant difference of drug resistance to antibiotics. Carbopenems, aminoglyeosides and furans are adopted in clinic during ESBLs-produeing E. eoli infection, while eephalosporins, nitrofuran and fluoroquinolone should be used during ESBLs non-producing E. eoli infection.