山区医院大肠埃希菌临床株的耐药性调查分析

Drug resistance of Escherichia coliisolates from hospitals in mountain area

目的探讨医院大肠埃希菌(ECO)的感染现状和耐药性,为临床医师治疗感染性疾病提供参考依据。方法大肠埃希菌培养鉴定严格按照《全国临床检验操作规程》,采用常规方法进行;药物敏感试验采用K-B法进行,结果判读按照CLSI最新折点标准进行,数据处理采用WHONET软件。结果 139株大肠埃希菌对常用抗菌药物均产生了较为严重的耐药性,ECO对氨苄西林耐药率最高,达93.5%;对亚胺培南敏感率最高,达到100.0%;大肠埃希菌耐药率>50.0%的抗菌药物有头孢唑林、头孢呋辛、磺胺甲噁唑/甲氧苄啶等;耐药率在40.0%～50.0%的抗菌药物有环丙沙星、头孢吡肟、头孢噻肟等。结论建议临床医师按照药敏试验结果合理使用抗菌药物,控制细菌耐药性的快速增长。

OBJECTIVE To approach infection status and drug resistance of Escherichia coli isolates to provide the scientific evidence for clinical treatment of infection diseases.METHODS According to National Clinical Laboratory Operation Rule,E.coli isolates were cultured and identified by routine methods.Drug susceptibility testing was performed by K-B methods.The data were analyzed by WHONET according to CLSI guideline.RESULTS Different serious drug resistance to common antibiotics occurred in 139 isolates of E.coli.The resistance rate to ampicillin（93.5%） was the highest,and the susceptibility rate to imipenem reached 100.0% as the highest one.Cefazolin,cefuroxime and compound of sulfamethoxazole and trimethoprim had resistance rates of more than 50.0%.The resistance rates to ciprofloxacin,cefepime and cefotaxime varied between 40.0% and 50.0%.CONCLUSION It is suggested that the clinicians should choose antibiotics based on the result of drug susceptibility testing in order to control the rapid increase of bacterial resistance.