大肠埃希菌在尿路感染的分布及耐药分析

Escherichia Coli Distribution and Analysis of Antibiotic Resistance in Urinary Tract Infection

目的分析大肠埃希菌在尿路感染中的分布特点及耐药现状,为临床合理用药提供参考。方法采用法国生物梅里埃公司VITEK2-Compact微生物分析仪进行细菌鉴定和药敏分析。对2008年4月—2010年4月住院及门诊尿路感染患者尿培养分离出的652例大肠埃希菌进行药敏分析,同时进行ESBLs检测。结果尿路感染大肠埃希菌中产ESBLs大肠埃希菌检出率为38%。药敏结果显示,大肠埃希菌对丁胺卡那霉素、呋喃妥因、美洛培南、亚胺培南等耐药率低,对青霉素类和环丙沙星、左旋氧氟沙星及庆大霉素耐药率大于60%。ESBLs阳性耐药率明显高于ESBLs阴性。病房标本分离菌株耐药率明显高于门诊。结论尿路感染中大肠埃希菌的耐药严重,尤是ESBLs阳性菌株,应加强耐药监测,指导临床合理用药,减缓耐药菌株出现。

[Objective] To analyze the distribution features of Escherichia coli（E.coli）and antibiotic resistance in urinary tract infection,and provide the reference for clinical use of antibiotic.[Methods]BIO MERIEUX VITEK2-Compact microbial analyzer was used for identification and antibiotic sensitivity test.652 strains of E.coli isolated from inpatients and outpatients with urinary tract infection during April 2008-April 2010 were collected for sensitivity analysis and ESBLs detection.[Results]The isolation rate of ESBLs producing E.coil was 38%.Drug sensitivity results showed that the resistance rate of E.coli was lower to amikacin,nitrofurantoin,meropenem,imipenem,while that was up to 60% to penicillins,ciprofloxacin,levofloxacin,and gentamicin.The resistance rate was significantly higher in ESBLs producing strains than in non-ESBLs producing strains.The resistance rate was higher in strains from inpatient than from outpatient.[Conclusion]The drug resistance of E.coli in urinary tract infection is extremely severe,especially for ESBLs-positive strains.It is necessary to enhance resistance surveillance,to guide clinical medication so as to slow down the appearance of drug-resistant strains.