大肠埃希菌临床分布及耐药性分析

Clinical distribution and drug resistance of escherichia coli

目的探讨济宁市某医院大肠埃希菌(ECO)的临床分布及对抗菌药物的敏感性,为临床感染的预防和治疗提供理论资料。方法对2008年5月-2009年6月从济宁市某医院临床分离的352株非重复的大肠埃希菌进行体外培养鉴定,采用法国生物梅里埃公司API系统进行大肠埃希菌的生化分析鉴定,测定细菌的最低抑菌浓度(MIC),并按照CLSI 2007年版标准,计算细菌对12种抗菌药物的敏感率、中介率和耐药率。结果 ECO从临床标本中以痰液和脓液标本的检出最常见,均占23.9%,其余依次是尿液、其他分泌物、血液、引流液、其他标本、胆汁,分别占19.3%、18.2%、5.7%、3.4%、3.4%、2.2%;大肠埃希菌对哌拉西林、磺胺甲噁唑/甲氧苄啶、头孢哌酮、头孢曲松有较高的耐药性,耐药率均>70.0%,对亚胺培南、阿米卡星较敏感。结论大肠埃希菌存在比较严重的耐药性,临床应尽早进行细菌培养和对抗菌药物的耐药性监测,以指导临床合理用药。

OBJECTIVE To investigate the distributions and drug resistance of Escherichia coli detected in one hospital of Jining,to provide valuable data for infection prevention and treatment.METHODS API half-automicroscan system was used to carry on the drug resistance analysis.The data on bacterial susceptibility testing from 352 clinical non-repeated strains of E.coli collected from May 2008 to Jun 2009 from First People′s Hospital of Jining was analyzed and the resistance,intermediate and susceptible rates of bacteria to all the 12 kinds of antimicrobial agents were calculated by routine custom dilution MIC method according to the CLSI（2007） guidelines,respectively.RESULTS E.coli was mostly isolated from sputum and sanies,both accounting for 23.9%,the following were urine and various types of secretions,blood,fluid drainage,bile and other specimens,respectively accounting for 19.3%,18.2%,5.7%,3.4%,2.2% and 3.4%.These strains were susceptible only to imipenem and amikacin,and the drug resistant rates to other antibiotics such as piperacillin,cotrimoxazole,cefoperazone and ceftriaxone were all more than 70.0%.CONCLUSION E.coli has high resistance to a lot of antibiotics.Bacterial culture and monitoring to their resistance to antibiotics should be performed early in clinical jobs to guide reasonable drug prescription and control nosocomial infection.