2011年我院大肠埃希氏菌耐药性监测

The first affiliated hospital of Kunming medical university 2011 surveillance of antimicrobial resistance in E.coli

目的调查我院2011年大肠埃希氏菌的耐药性,以指导临床合理使用抗菌药和预防院内感染。方法回顾分析我院2011年检出的大肠埃希氏菌的耐药情况,并与2010年的做比较分析。结果 2011年在我院分离到3878株细菌,肠杆菌科细菌1765株,大肠埃希氏菌为728株(其中ESBLS阳性菌株为451株),占全部分离菌株的18.8%,占肠杆菌科细菌的41.2%,大部分来自尿标本,尿标本检出484株(占66.5%),其次为呼吸道标本,检出184株(占25.3%)。2010年我院检出的大肠埃希氏菌560株,其中ESBLS阳性菌株的比例为67%,ESBLS阳性菌株除对哌拉西林他唑巴坦、亚胺培南、头孢替坦、妥布霉素及阿米卡星保持低度耐药外,对其余抗菌药物的耐药率均高于50%。而2011年我院检出大肠埃希氏菌728株,其中ESBLS阳性菌株的比例为61.9%,ESBLS阴性菌株对常用抗菌药物耐药率大于30%以上的抗菌药物分别是左氧氟沙星、庆大霉素和阿莫西林克拉维酸,对环丙沙星、哌拉西林和复方新诺明的耐药率的均大于40%,而对氨苄青霉素的耐药率大于75%。ESBLS阳性菌株只有对头孢哌酮舒巴坦、头孢吡肟、碳青霉烯类及丁胺卡那保持低度耐药性,对其余常用抗菌药物的耐药率大部分高于70%。结论我院大肠埃希氏菌对头胞哌酮舒巴坦及碳青霉烯类抗菌药物仍保持较高的敏感性,对部分头孢类抗菌药物的耐药性有下降的趋势,但对常用抗菌药物的耐药率仍明显。

Objective To investigate the antimicrobial resistance of E. coli strains isolated from patients in our hospital during 2011. Methods Clinical isolates of E. coli were collected from our hospital. The results of drug susceptitibility test were ana- lyzed. Results Of the 3878 clinical strains were collected, E. eoli was 728 （ 18. 8% ）, and 66. 5% were isolated from urine speci- men. The total prevalence of ESBLs-producing strains in E. coli was 61.9%. 2010, of the 560 E. coli strains were collected, the total prevalence of ESBLs-producing strains in E. coXi was 67% . Up to 50% ESBLS-producing strains were resistant to other antibiotic, but,Piperacillin-tazobactam,AmikacinJmipenem,Cefotetam and Tobramvcin. 2011 ,up to 70% ESBLS-producing strains were resist- ant to other antibiotic,but cefoperazone-sulbzctam,Cefepime,Anikacin,Imipenem and Meropenem. Conclusion Compared with the data in 2011 ,Imipenem, Meropenem and cefoperazone-sulbactam are still highly active against E. coll. But the antimicrobial resist- ance of E. coli is still aserious problem in our hospital. The surveillance of antimicrobial resistance is very important for guidingration- al antimicrobial therapy in heahhcare facilityes.