大肠埃希菌临床科室分布及耐药性

Distribution of Escherichia coli in clinical departments and analysis of drug resistance

目的了解医院培养分离出大肠埃希菌(ECO)的临床科室、标本分布及其耐药性,为临床合理选用抗菌药物提供科学依据。方法对2011年1月-2013年1月微生物室从各类临床标本中分离出的681株大肠埃希菌进行统计,分析其在不同科室、标本中的检出;ECO分离培养与鉴定严格按卫生部法定的临床微生物学检验常规方法进行;药敏试验检测采用K-B法操作和CLSI最新折点标准判断药敏数据为敏感、中介、耐药。结果神经内科检出ECO最多108株占15.9%,其次为心肺血管科103株占15.1%;标本分布以尿液及痰液检出最多为429、121株,分别占63.0%、17.8%;ECO对哌拉西林的耐药率最高,达82.7%,而对碳青霉烯类抗菌药物亚胺培南敏感率为100.0%。结论神经内科是大肠埃希菌感染的重点病区,泌尿系统是大肠埃希菌感染的重要部位,大肠埃希菌已显示多药耐药趋势,必须重点监控。

OBJECTIVE To understand the distribution of the Escherichia coli cultured from different clinical departments and specimens and analyze the drug resistance so as to provide the scientific evidence for rational use of antibiotics. METHODS A total of 681 strains of E. coli isolated from various clinical specimens obtained from the microbial chamber from Jan 2011 to Jan 2013 were taken for statistics, and the detection rates of the strains from different departments and specimens were statistically analyzed. Bacterial culture and identification were carried out by the routine methods of clinical microbiology inspection that were formulated by the Ministry of Health. The susceptibility testing was performed by K-B methods, the susceptibility testing results were assessed by the newest breakpoints of CLSI to judge whether the drug susceptibility data were sensitive, mediate or resistant. RESULTS The 108 strains （15.9 %） of E. coli isolated from neurology department were the most; E. coli isolated from the cardiovascular department were 103 strains （15. 1%）. There were 429 strains （63. 0%） isolated from urine and 121 strains （17.8%） isolated from sputum. The drug resistance rate of E. coli to piperacillin was the highest, up to 82. 7%, while the drug susceptibility rate to such carbapenem antibiotics as imipenem was 100.0%. CONCLUSION The high-risk ward of E. coli infection is department of neurology. Urinary tract is the predominant site with E. coli infection, the E. coli has indicated the trend of multidrug-resistance, on which the monitoring should be focused.