基层医院消化内科大肠埃希菌的感染现况及耐药性

Escherichia coli infection and drug susceptibility in gastroenterology department of a township hospital

目的:了解基层医院消化内科大肠埃希菌的感染情况和评价《抗菌药物临床应用专项整治活动方案》的实施效果,为临床医生合理应用抗菌药物提供科学依据.方法:用法国梅里埃全自动微生物鉴定和药敏分析仪(france automatic microorganism identification and drug sensitivity analyzer,V I T E K-2)对南方医科大学附属小榄医院2012-01/2013-12消化内科患者标本中分离的大肠埃希菌进行药敏分析,比较分析《抗菌药物临床应用专项整治活动方案》干预前(2012年)和干预后(2013年)消化内科大肠埃希菌的耐药性.结果:2012年和2013年分别分离出46株和50株大肠埃希菌;其主要来源于泌尿系统感染,分别占52.2%和74.0%;该项方案干预后,产超广谱β内酰胺酶(extended spectrumβlactamases)大肠埃希菌检出率由63.0%降为56.0%,其对常用β内酰胺类药物的耐药率低于干预前,尤其是氨曲南、头孢他啶和头孢吡肟的耐药率显著降低(P<0.01).结论:该项方案干预后,消化内科标本分离的大肠埃希菌对常用14种抗菌药物的耐药率低于干预前,其中有3种抗菌药物的耐药率显著降低.

AIM： To investigate the current situation of Escherichia coli（E. coli） infection and drug susceptibility in gastroenterology department of township hospitals and to evaluate the efficiency of resistance control program that was implemented in our hospital, so as to provide a scientific basis for clinical rational use of antibiotics. METHODS： A France automatic microorganism identification and drug sensitivity analyzer（VITEK-2） was used for pathogen identification and drug sensitivity analysis. The drug resistance pattern of E. coli isolated from the samples obtained in 2012（before the program was implemented） with that obtained in 2013（after the program was implemented）. RESULTS： A total of 46 E. coli strains were isolated in 2012, and the detection rate of ESBLs-producing strains was 63.0%. Approximately 52.2% of the strains were isolated from the urinary system. A total of 50 E. coli strains were isolated in 2013, and the detection rate of ESBLs-producing strains was 56.0%. Approximately 74.0% of the strains were isolated from the urinary system. The rate of resistance of E. coli to beta-lactamases in 2013 was significantly lower than that in 2012, especially aztreonam, ceftazidime and cefepime（P 0.01）. CONCLUSION： The rates of resistance of E. coli to 14 kinds of routine antibacterial drugs in 2013 are lower than those in 2012 in the gastroenterology department. The rates of resistance of E. coli to 3 kinds of antibacterial drugs decrease significantly.