儿童感染大肠埃希菌连续5年的感染分布及耐药性动态变迁

Changes of Distribution and Antimicrobial Resistance of Escherichia Coli in Children

目的了解儿童感染大肠埃希菌的分布及耐药性变迁情况。方法采用API和VITEK-2鉴定系统进行细菌鉴定,采用纸片扩散法进行药敏试验,应用WHONET 5.4软件分析病原菌的分离率及耐药率。结果 2006—2010年共分离到大肠埃希菌697株,主要分离自尿液、脓汁、痰、血液等标本,连续5年产超广谱β-内酰胺酶大肠埃希菌的检出率分别为52.5%、42.5%、55.6%、46.4%、48.7%,差异无统计学意义(P>0.05)。大肠埃希菌对青霉素类、一代、二代头孢菌素的耐药率较高,对阿米卡星和含有酶抑制剂的药物耐药率较低,对碳青霉烯类药物耐药率最低,只有1株耐药。结论大肠埃希菌是我院儿童细菌感染的重要致病菌,检测其分布及耐药性的变迁可指导临床合理使用抗菌药物。

Objective To find out dynamic changes of distribution and antimicrobial resistance of Escherichia coli(E.coli)isolated from different samples in infected children. Methods The isolated bacteria were identified by using API and VITEK-2 system,and their antimicrobial resistances were determined by Kirby-Bauer method.Data of isolation rate and drug resistant rate were analyzed by using WHONET 5.4 software. Results Total 697 E.coli isolates were collected from 2006 to 2010.These isolates were most commonly collected from samples of urine,pus,sputum and blood.During the 5 years,the detection rates of the ESBLs-producing E.coli were 52.5%,42.5%,55.6%,46.4%,and 48.7%,respectively,with no statistical difference(P>0.05).E.coli demonstrated much higher resistance rate to penicillins,and the first or second generation cephalosporins;but much lower to amikacin and β-lactamase inhibitors;and the lowest rate to carbopenems,with only one strain being found. Conclusion E.coli is the main pathogen isolated from infected children.Monitoring the changes of distribution and drug resistance could guide reasonable application of antibiotics.