产超广谱β-内酰胺酶大肠埃希菌尿路感染的耐药性分析

Drug Resistance Analysis of Extended Spectrum Beta-lactamases-producing Escherichia coli in Patients with Urinary Tract Infection

目的了解大肠埃希菌所致尿路感染中产超广谱β-内酰胺酶(ESBLs)菌株的耐药情况,为临床抗感染治疗提供参考。方法分析2001年1月-2005年12月,尿路感染患者尿培养分离出的42株产ESBLs大肠埃希菌对15种抗菌药物的耐药情况。结果产ESBLs大肠埃希菌对亚胺培南、美罗培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的耐药率均<10.00%,对青霉素类、头孢菌素类、喹诺酮类耐药率较高(>85.00%);产ESBLs菌株对青霉素类、头孢菌素类、喹诺酮类、阿米卡星的耐药性高于非产ESBLs菌株。结论治疗大肠埃希菌感染时,需根据药敏结果选用抗菌药物;碳青酶烯类、β-内酰胺类/β-内酰胺酶抑制剂是治疗产ESBLs大肠埃希菌所致尿路感染的首选药物。

OBJECTIVE To investigate the drug resistance of the extended spectrum beta-lactamases（ESBLs）-producing strains of Escherichia coli in patients with urinary tract infection.METHODS Forty two strains of ESBLs-producing E.coli were isolated from hospitalized patients with the urinary tract infection from Jan 2001 to Dec 2005.The drug resistance against 15 antibiotics was analyzed.RESULTS The drug resistance rates of ESBLs-producing E.coli to imipenem,meropenem,cefoperazone/sulbactam and piperacillin/tazobactam were all lower than 10.00%,but to penicillins,cephalosporins and quinolones were relatively high（〉85%）.The drug resistance of ESBLs-producing E.coli strains to penicillins,cephalosporins,quinolones and amikacin was higher than that of non-ESBLs-producing strains.CONCLUSIONS We should choose antibiotics on the basis of drug resistance test to treat urinary tract infection caused by E.coli.Carbopenems,and β-lactam/β-lactamase inhibitor combinations are the first choice drugs for experimental treatment.