大肠埃希菌的分布与耐药性分析

Distribution and drug resistance of Escherichia coli

目的了解大肠埃希菌在临床各种标本中的分布及耐药性,为临床合理用药提供参考依据。方法统计分析2013年1-12月医院各种临床标本分离出的140株大肠埃希菌分布及耐药性,药敏试验采用K-B纸片琼脂扩散法,采用WHONET5.4-5.5软件分析数据。结果 2013年3 304份临床各种标本中分离出病原菌共1 062株,其中大肠埃希菌140株,占13.18%;大肠埃希菌在中段尿、血液、分泌物、痰液等不同临床标本中分别占44.44%、22.22%、19.08%、6.81%;大肠埃希菌耐药性严重,除对亚胺培南100.00%敏感外,对哌拉西林/他唑巴坦、阿米卡星、头孢哌酮/舒巴坦和头孢西丁的耐药率均较低,分别为1.89%、3.77%、11.32%和20.75%;而对其他青霉素类、头孢菌素类、喹诺酮类及氨基糖苷类等抗菌药物耐药率均较高;产ELBLs大肠埃希菌的检出率为55.70%。结论标本来源不同,大肠埃希菌的分布和耐药性不同,临床医师应根据药敏试验结果合理选择使用抗菌药物。

OBJECTIVE To investigate the distribution and drug resistance of the Escherichia coli strains isolated from the clinical specimens so as to provide guidance for reasonable clinical use of antibiotics.METHODS The distribution and drug resistance of the 140 strains of E.coli that were isolated from the clinical specimens from Jan2013 to Dec 2013 were statistically analyzed,the drug susceptibility testing was performed by using K-B disk agar diffusion method,and the data were analyzed with the use of WHONET5.4-5.5software.RESULTS A total of 1062 strains of pathogens were isolated from the 3 304 clinical specimens in 2013,of which 140（13.18%）strains were E.coli.Of the isolated E.coli strains,44.44% were isolated from the midstream urine specimens,22.22%were isolated from the blood specimens,19.08% were isolated from the secretions specimens,and 6.81% were isolated from the sputum specimens.The E.coli strains were highly drug-resistant,the drug susceptibility rate to imipenem was 100.00%,the drug resistance rates to piperacillin-tazobactam,amikacin,cefoperazone-sulbactam,and cefoxitin were 1.89%,3.77%,11.32%,and 20.75%,respectively;however,the drug resistance rates to penicillins,cephalosporins,quinolones,and aminoglycosides were high.The isolation rate of ESBLs-producing E.coli was 55.70%.CONCLUSION The E.coli strains isolated from different specimens sources vary in the distribution and drug resistance.It is necessary for the clinicians to reasonably use antibiotics based on the results of the drug susceptibility testing.