大肠埃希菌超广谱β-内酰胺酶的检测及多重耐药性分析

Detection and multi-drug resistance analysis of extended-spectrum β-lactamase producing Escherichia coli

目的分析大肠埃希菌的耐药性、产超广谱β-内酰胺酶(ESBLs)情况、标本来源及临床科室分布特点。方法运用全自动微生物分析仪鉴定细菌和筛选ESBLs,采用琼脂稀释法测定最小抑菌浓度,用卡方检验分析数据。结果共分离出大肠埃希菌150株,其中敏感菌占29.3%,多重耐药菌占25.3%;阿米卡星耐药率最低(8.7%),复方新诺明耐药率最高(54.0%),ESBLs检出率为50%,阿米卡星、复方新诺明、头孢他啶、左氧氟沙星和呋喃妥因在ESBLs阳性组和阴性组的耐药率差异有统计学意义(P<0.05);标本主要来源于尿液(39.3%),感染主要发生于泌尿外科(20.0%)。结论敏感、耐药和多重耐药的大肠埃希菌同时存在,ESBLs与大肠埃希菌的耐药性关系密切。

Objective To investigate the drug resistance, ESBLs - production, specimens sources and clinical distribution of Escherichia coli. Methods Bacteria identification and ESBLs screening were carried out by using automated microbiology ana lyzer, while the minimum inhibitory concentration was determined by using agar dilution method. Chi square test was used for data analysis. Results A total of 150 Eseheriehia coli strains were isolated, and the proportions of sensitive bacteria and multi- pie - drug resistant bacteria were 29.3% and 25.3% , respectively. The 150 Escherichia coli strains showed lowest drug resist- ance rate to amikacin（ 8. 7% ）, and highest drug resistance rate to trimethoprim/Sulfamethoxazole（54.0% ）. The detection rate of ESBLs was 50%. There were significant differences in resistant rates to amikacin, trimethoprim/Sulfamethoxazole, ceftazi- dime, levofloxacin and nitrofurantoin between the ESBLs - postive group and ESBLs - negative group （ P 〈 0.05 ）. The source of specimens was mainly urine and Escherichia coli infection was frequently found in urology department（20.0% ）. Conclusion Escherichia coli showed drug resistance at different degrees. There was a close relation between ESBLs and the drug resistance of Escherichia coli.