新生儿感染大肠杆菌的耐药性分析

Analysis on Antimicrobial Resistance of Escherichia coli in Neonates

目的了解新生儿感染大肠杆菌及耐药情况,为临床治疗及新生儿感染的控制提供依据。方法对本院2007年4月-2008年5月临床检出菌,用法国生物梅里埃系统VITEK2-COMPACT鉴定及药敏分析,并用双纸片法对新生儿科分离的大肠杆菌进行超广谱β-内酰胺酶(extend-spectrum β-lactamases,ESBLs)检测,同时对产ESBLs及非产ESBLs菌株进行耐药性分析。结果新生儿病房总共检出大肠杆菌113株,其中检出ESBLs阳性菌株66株,产酶率为58.41%。在12种抗生素中,耐药率最低的是亚胺培南。将47株ESBLs阴性的大肠杆菌平均耐药率与66株ESBLs阳性的大肠杆菌的平均耐药率相比较差异有显著性。结论新生儿病房等免疫力低下的患者是大肠杆菌的易感人群,且以呼吸道感染为主。治疗感染产ESBLs大肠杆菌的有效药物为抗生素与酶抑制的复方制剂和亚胺培南。

Objective To investigate the antimicrobial resistance of Escherichia coil （E. coil） in neonates, and to provide a foundation for the application of clinical antibiotics. Methods The bacteria which were isolated from April, 2007 to May, 2008 in our hosoital were identified by API system. ESBLs in the isolated E. coil from neonates were detected by double disk test. and the drug resistance of ESBLs producers and nonproducers was analyzed. Results Totally 113 strains of E. coil were isolated from neonates, the percentage of producing ESBLs was 58.41% （66/113）. The resistant rate to imipenem was the lowest in 12 kinds of antibiotics. The drug resistance rate of ESBLs producers was significantly higher than that of ESBLs nonproducers. Conclusiens The neonatal patients are easy to infect E. coil, and the majority was with respiratory tract infection. Imipenem and the compound preparations of antibiotics and enzyme inhibitor are the effective drugs to treat the neonatal patients who infect with ESBLs- producing E. coll.