老年患者胆道感染大肠埃希菌的耐药性分析

Antimicrobial resistance of Escherichia colicausing biliary tract infections in senile patients

目的探讨老年患者胆道感染大肠埃希菌(ECO)的耐药性,为临床合理用药提供依据。方法严格按照《全国临床检验操作规程》进行ECO培养,采用K-B法对180株ECO进行药物敏感试验;对产超广谱β-内酰胺酶(ESBLs)菌株的检测采用双纸片扩散法。结果 180株ECO对常用抗菌药物均产生了不同程度的耐药性,但对亚胺培南、美罗培南敏感率为100.0%,检出产ESBLs ECO 71株,检出率为39.4%,产ESBLs ECO对常用抗菌药物的耐药率明显高于非产ESBLs ECO,但产ESBLs ECO对头孢西丁、阿米卡星、亚胺培南等敏感,尤其是对亚胺培南的敏感率为100.0%。结论 ECO已对多种常用抗菌药物产生耐药性,尤其是产ESBLs ECO对大部分抗菌药物耐药率较高,所以临床中应合理使用抗菌药物。

OBJECTIVE To approach the antimicrobial resistance of Escherichia coli causing biliary tract infections in senile patients and provide experimental evidence for clinically reasonable use of antibiotics.METHODS The E.coli strains were cultured by referring to National Guide to Clinical Laboratory Procedures.The drug susceptibility testing was performed by K-B methods for 180 strains of E.coli.The extended spectrum β-lactamase（ESBLs）-producing strains were detected by double discs diffusion method.RESULTS The susceptibility testing of 180 E.coli strains against commonly used antibiotics indicated varying antimicrobial resistance,however,E.coli was 100.0% susceptible to imipenem and meropenem;totally 71（39.4%） strains of ESBLs-producing E.coli were detected;the susceptibility testing showed that the drug resistance rate of the EBSLs-producing E.coli was distinctly higher than that of non-ESBLs-producing strains,but EBSLs-producing E.coli was susceptible to cefoxitin and amikacin,imipenem in particular,with the drug susceptibility rate of 100.0%.CONCLUSION E.coli has produced drug resistance to multiple common antibiotics,ESBLs-producing E.coli is resistance to most antibiotics,so it is necessary to reasonably use antibiotics.