2010～2011年社区感染和医院感染大肠埃希菌耐药性分析

The antimicrobial bacterial resistance analysis of E.coli from community acquired and hospital infection from 2010 to 2011

目的:分析社区和医院分别感染大肠埃希菌的耐药性及其变迁,为社区和临床医师合理用药提供科学依据。方法:使用VI TEK-2对2010～2011年社区和医院感染患者各种标本分离出的933株大肠埃希菌进行常规药敏试验,并比较社区和医院感染大肠埃希菌的耐药性。结果:收集到社区和医院感染大肠埃希菌分别为575株、358株,产ESBLs菌株检出率分别为51.0%、68.2%。药敏结果显示933株大肠埃希菌对厄他培南、亚胺培南、哌拉西林/他唑巴坦、头孢替坦、呋喃妥因、阿米卡星的耐药率均低于5%,社区感染和医院感染中分离的大肠埃希菌对以上6种抗生素的耐药率无明显差别(P>0.05),对其他12种抗生素(氨苄西林、氨苄西林/舒巴坦、头孢唑林、头孢他啶、头孢曲松、头孢吡肟、氨曲南、庆大霉素、妥布霉素、环丙沙星、左旋氧氟沙星、复方新诺明)的耐药率有显著差异(P<0.05)。结论:社区感染大肠埃希菌对常用抗菌药物的耐药率和产ESBLs菌株阳性率均低于医院感染大肠埃希菌。社区和医院感染大肠埃希菌对头孢替坦、哌拉西林/他唑巴坦和碳青霉烯类抗生素敏感性最高。产ESBLs菌株对抗菌药物的耐药率明显高于非产ESBLs菌株,因此加强抗菌药物管理,根据药敏结果合理使用抗菌药物,是减少耐药株产生的关键。

Objective To study the clinical distribution and antimicrobial bacterial resistance of E.coli from community acquired and hospital infection for the guidance of rational use of antibiotics. Methods The drug susceptibility test were analyzed by Vitek 2 automatic microbiology analytical system for the total isolated 933 strains. The antimicrobial bacterial resistance of E.coli from community acquired and hospital infection were also compared from 2010 to 2011. Results The number of E.coli strains was 575 from community acquired,358 from hospital infection.The rate of ESBLs（＋） strains from community acquired was 51.0% and 68.2% from hospital infection. The drug susceptibility test of the 933 E. coil strains showed that the drug resistance rates to Ertapenem,lmipenem,Piperacillin/Tazobactam,Cefotetan,Furadantin and Amikacin were lower than 5.0%.There was no statistical significance （P 〉0.05）between the E.coli strains from community acquired and hospital infection. The drug resistance rates of the two kinds of strains was significant different （P〈0.05） to the other 12 antibiotics （AmpiciI,Ampicil/Sulbactam Cefazolin,Ceftazidime,Ceftriaxone,Cefepime,Aztreonam, Cidomycin Tenebrimycin,Ciprofloxacin Levofioxacin and Bactrim）. Conclusions The antimicrobial bacterial resistance rate and ESBLs （＋） rate of E.coli from community acquired is lower than that of E.coli＇s from hospital infection. Both strains were high sensitive to Cefotetan Piperacillin/Tazobactam and KPCs.The antimicrobial bacterial resistance rate of ESBLs （＋） strains is significant higher than that of ESBLs （-） strains＇.ln order to reduce the drug-resistant strains,it＇s necessary to use antibiotics rationally.