泌尿生殖道分离的大肠埃希菌耐药性分析

Drug resistance analysis of Escherichia coli separated from Genitourinary tract

目的了解泌尿生殖道分离大肠埃希菌对抗菌药物的耐药情况，为临床治疗和研究提供依据。方法回顾分析近2a来我院性病门诊患者泌尿生殖道分离的174株大肠埃希菌的耐药情况，细菌鉴定分析及药敏试验采用法国生物梅里埃VITEK32全自动微生物分析系统及其配套试剂。结果174株大肠埃希菌中，超广谱p．内酰胺酶（ESBLs）阳性96株，阳性率55．2％，ESBLs阴性78例，占全部分离标本的44．8％；大肠埃希菌对氨苄西林、复方新诺明、头孢唑啉的耐药率最高，分别为86．2％、71.3％、63．8％；对呋喃妥因、头孢他啶、哌拉西林，1也唑巴坦也保持较低的耐药率，分别为2.3％、4．0％、3．5％；对亚胺培南则全部敏感。产ESBLs大肠埃希茵对氨苄西林、头孢唑啉、头孢曲松及环丙沙星、妥布霉素、复方新诺明的耐药率明显高于非产ESBLs大肠埃希菌。结论治疗大肠埃希菌引起的泌尿生殖道感染应根据药敏情况结果及患者病情进行合理用药，细菌的耐药性分析对指导临床合理用药具有重要意义。

Objective To investigate the drug resistance status of Escherichia coli separated from Genitourinary tract, and provide the basis for clinical therapy and research. Methods 174 cases of patients with Escherichia coli infection in the venereal disease clinic service were analysed, the bacteria identification and susceptibility test were detcted by VITEK32 automatic analytical system. Results 96 cases out of 174 were ESBLs positive, and the rate was 55.2%; the resistance to arnpicillin, TMP-SMZ, cephazoline were most seen, and the positive rate was 86.2%, 71.3%, 63.8%, respectively; and the resistance to furantoin, ceftazidime piperacillin were merely seen, and all the bacteria strains were sensitive to imipenem. The resistance rates to ampicillin, cephazoline, ceftriaxone, ciprofloxacin, tenebrimycin, TMP-SMZ of ESBLs positive Escherichia coli were higher than the ESBLs negative Escherichia coll. Conclusions The antibiotic drug should be chosen according to the susceptibility test and the pathogenetic condition, the drug resistance analisis was important to clinical therapy.