近3年尿路感染产ESBLs大肠埃希菌的分析

The analysis of extended-spectrum beta-lactamase-producing Escherichia coli on urethral infection

目的了解本地区尿路感染中产ESBL大肠埃希菌检出率和细菌产生耐药的原因,分析耐药菌株对尿路感染患者抗菌治疗的影响。方法对2007—2009 3年来尿路感染患者中段尿分离大肠埃希菌,用法国Bio-Merieax系统进行细菌鉴定和药敏试验;ESBLs酶用表型确证试验检测。结果 2007年、2008年和2009年,产ESBLs大肠埃希菌分别为10株(45.4%)、14株(58.3%)、15株(48.4%)。菌株对亚胺培南、美罗培南、阿米卡星、哌拉西林/三唑巴坦敏感率较高,对常用抗菌药物呈多重耐药状态。结论尿路感染病因学和病原菌的耐药特点是难以预测的,及时进行病原体培养和药物敏感试验,根据药敏结果采取措施,才是控制感染的关键。

Objective To study incidence of extended-spectrum beta-lactamase（ESBLs）-producing Escherichia coli on urethral infection,and the tendency of antibiotic tolerance.Methods Urine samples of Middle section in patiens with urethral infection were cultured in 2007~2009,the bacterial and antimicrobial susceptibility tests were performed by ATB-Expression.ESBLs-producing isolates were confirmed by means of phenotypic confirmatory tests as recommended by the CLSI/NCCLS.Results 10（45.4%）,14（58.3%）,15（48.4%）strains of ESBLs-producing Escherichia coli were isolated in 2007,2008 and 2009,respectively.The strains were susceptible to imipenem,meropenem,amikacin and piperacillin /tazobactam.Conclusion The prompt initiation of effective antimicrobial treatment based on the results of antimicrobial susceptibility test is essential in patients with ESBLs-producing Escherichia coli.Infection,and empirical therapy should base on patient demographics/medical history,presumed aetiology and local resistance patterns until more definitive guidelines become available.