442株大肠埃希菌临床感染分布及耐药性分析

Analysis on clinical infection distribution and drug resistance of 442 strains of Escherichia coli

目的分析442株大肠埃希菌临床感染分布及耐药性,为治疗大肠埃希菌感染及医院感染控制提供依据。方法对2013年临床送检的各类标本进行细菌培养及鉴定,采用微量肉汤稀释法(MIC)法检测大肠埃希菌对临床常用抗菌药物的敏感性,采用WHONET5.5及SPSS13.0软件对数据进行统计分析。结果 442株大肠埃希菌主要分离自中段尿、分泌物,产ESBLs大肠埃希菌检出率为61.3%。442株大肠埃希菌对青霉素类、头孢菌素类、氟喹诺酮类抗菌药物耐药率较高,对β-内酰胺/β-内酰胺酶抑制剂复合物敏感性较好,对碳青霉烯类抗菌药物敏感性最高。产ESBLs菌株对临床常用抗菌药物耐药率高于非产ESBLs菌株。结论大肠埃希菌耐药性较为严峻,产ESLBs大肠埃希菌常表现出对多种不同类型抗菌药物耐药,治疗大肠埃希菌重症感染首选碳青霉烯类抗菌药物。

Objective To analyze the clinical infection distribution and drug resistance status of 442 strains of Escherichia coli to provide the basise for the treatment of Escherichia coli infection and the control of nosocomial infection.Methods The clinically submitted various kinds of specimens during 2013 were performed the bacterial culture and identification.The susceptibility of Escherichia coli to commonly used bacterial drugs were detected by adopting the MIC method.The data were analyzed by WHO-NET V5.5 and SPSS V13.0 softwares.Results 442 strains of Escherichia coli were isolated from the middle urine and secretion. The detection rate of ESBLs-producing Escherichia coli was 61.3%.442 strains of Escherichia coli had the high resistance to peni-cillins,cephalosporins and fluoroquinolones,better sensitivity toβ-lactam/β-lactamase inhibitor compounds and highest sensitivity to carbapenems.ESBLs-producing Escherichia coli had the higher resistance to commonly used antibacterial drugs than non-ESBLs-producing Escherichia coli .Conclusion The drug resistance of Escherichia coli is severe.ESBLs-producing Escherichia coli are u-sually resistant to many different types of antimicrobial drugs.Carbapenems are the first choice to treatment of severe infections of Escherichia coli .