252株大肠埃希菌的临床分布及药敏情况分析

Clinical distribution of 252 strains of Escherichia coli and drug susceptibility

目的了解本院2010年大肠埃希菌的临床分布及其对常用抗菌药物的敏感性,指导临床合理选用抗菌药物。方法临床送检的各种标本用常规方法进行分离培养,用长沙天地人2010系统进行鉴定,并用"微量肉汤"稀释法进行药敏实验。结果共检出大肠埃希菌252株,其临床分布为:痰88株(34.9%),尿液76株(30.2%),分泌物27株(10.7%),脓液23株(9.1%),血液11株(4.4%),胆汁10株(4.0%),咽拭子9株(3.6%),腹水4株(1.6%),其他4株(1.6%)。大肠埃希菌对19种抗菌药物敏感性最高的是美罗培南(100%),其次是哌拉西林-他唑巴坦(98.0%);耐药性最高的为氨苄西林(92.1%),其次为头孢唑啉(79.8%)。252株大肠埃希菌中有121株产ESBLs,阳性率为48.0%。结论本院大肠埃希菌分布较广,主要检出部位为呼吸道、泌尿系统,其对临床常用抗菌药物的耐药率均较高,19种抗菌药物中耐药率>50%的有10种。医院应加强抗菌药物使用的管理,提高抗菌药物的合理使用。

Objective To determine the clinical distribution and drug resistance of 252 strains of Escherichia coli in our hospital in 2010 to guide the reasonable use of antibacterials.Methods The clinical specimens were isolated and cultured with general method,and identified with CS TDR 2010 identification system.The antibacterial sensitivity was detected with the broth microdilution test.Results The 252 strains of Escherichia coli were detected from sputum（34.9%）,urine（30.2%）,secretion（10.7%）,pus（9.1%）,blood（4.4%）,bile（4.0%）,nasopharyngeal swab（3.6%）,ascites（1.6%）,and other specimens（1.6%）.The highest susceptibility rate of Escherichia coli to 19 antimicrobials was meropenem（100%）,followed by piperacillin-tazobactam（98.0%）.The highest resistant rate of Escherichia coli was ampicillin（92.1%）,and the second was cefazolin（79.8%）.There were 121 strains of Escherichia coli producing ESBLs,and the rate of ESBLs was 48.0%.Conclusion The clinical distribution of Escherichia coli is wide in the respiratory tract and the urinary tract.The resistant rate of Escherichia coli that is above 50% amounts to 10 antibacterials.The use of antibacterials should be controlled strictly.