不同疾病住院患者大肠埃希菌耐药性研究

Antibiotic resistance of Escherichia coliin hospitalized patients with various diseases

目的了解不同疾病患者大肠埃希菌流行病学分布及耐药性。方法查阅2009年12月-2011年2月细菌培养为大肠埃希菌的住院患者253例,8种疾病各收集40例次,统计不同疾病患者大肠埃希菌的耐药率。结果不同疾病患者分离的大肠埃希菌对喹诺酮类药物耐药率不尽相同,其中恶性肿瘤患者耐药率最高达70.0%,其次为长期口服糖皮质激素和慢性阻塞性肺疾病(COPD)患者,为65.0%,器官移植患者耐药率也偏高,为62.5%;8种疾病中器官移植的ESBLs检出率最高达80.0%,其次COPD患者为52.5%,外伤患者检出率最低是25.0%;同一例患者基础疾病种类越多,耐药性也越严重。结论大肠埃希菌的耐药性比较严峻,所以应加强细菌耐药监测,了解耐药变迁,为临床合理用药提供依据,防止耐药菌株的传播。

OBJECTIVE To explore the epidemiology and drug resistance of Escherichia coli in various groups.METHODS From Dec 2009 to Feb 2011,a total of 320 patients with bacteria cultured as E.coli were selected,with 8 types of diseases and 40 cases with each,statistical analysis of the drug resistance of E.coli in various groups was performed.RESULTS E.coli in different group of patients varied in drug resistance to quinolone antibiotics,drug resistance rate of the patients with malignant tumor reached to 70.0%,followed by the patients suffered from COPD with the long-term use of corticosteroids（65.0%）,the resistance rate of the patients undergoing organ transplantation was relatively high（62.5%）;the detection rate of ESBLs of the organ transplantation of 8 diseases was the highest（80.0%）,followed by the patients with COPD patients（52.5%）,the detection rate of the patients with trauma was the lowest（25.0%）;the more primary diseases the patient had,the more serious the drug resistance would be.CONCLUSION The drug resistance of E.coli is terribly severe,it is necessary to strengthen the surveillance for bacterial resistance and understand the change of drug resistance so as to provide the basis for clinical reasonable use of antibiotics and prevent the spread of resistant strains.