2011年医院大肠埃希菌临床分布及耐药性分析

Distribution and antibiotics resistance of clinical isolates of Escherichia coli in 2011

目的分析医院大肠埃希菌的临床分布及常用抗菌药物的耐药情况,为临床合理使用抗菌药物提供依据。方法用VITEK-2Compact对大肠埃希菌进行鉴定和药敏试验。结果 485株大肠埃希菌产ESBLs菌株355株,占73.2%,检出较多的科室是肾内科、小儿外科和重症医学科;感染部位以泌尿道和呼吸道为主;药敏试验结果分析显示,大肠埃希菌对亚胺培南、厄他培南、哌拉西林/他唑巴坦、头孢替坦和呋喃妥因的耐药率较低,均<9.0%,而氨苄西林、头孢唑林、头孢曲松和氟喹诺酮类抗菌药物耐药性较高,均>70.0%;不同感染部位的菌株对头孢他啶和头孢吡肟的耐药性差异较大。结论临床分离大肠埃希菌的产ESBLs率较高,医院应加强抗菌药物的管理和医院感染的监控,合理使用抗菌药物,以阻止产ESBLs菌株的播散和流行。

OBJECTIVE To investigate the distribution and antibiotics resistance of clinical isolates of Escherichia coli to commonly used antibiotics so as to guide the reasonable use of antibiotics.METHODS The identification of the E.coli and the antimicrobial susceptibility testing were performed by VITEC2-compact.RESULTS There were 355ESBLs-producing strains of 485strains of E.coli,the positive rate was 73.2%.The E.coli infections were mainly seen in nephrology department,pediatric surgery,and intensive care unit;the urinary tract and respiratory tract were the predominant infection sites.The drug susceptibility testing result showed that drug resistance rates of the strains to imipenem,ertapenem,piperacillin,tazobactam,cefotetan,and furantoin were less than 9.0%,but the drug resistance rates to ampicillin,cefazolin,ceftriaxone,and fluoroquinolones were more than 70.0%.The strains isolated from different infection sites varied in the drug resistance to ceftazidime and cefepime.CONCLUSIONThe detection rate of the clinical isolates of ESBLs-producing E.coli is high,thus the hospital should strengthen the management of antibiotics and the monitoring of nosocomial infections and reasonably use antibiotics so as to prevent the spread and prevalence of the ESBLs-producing strains.