肠杆菌科细菌环丙沙星耐药株与敏感株耐药性分析

Enterobacteriaceae Ciprofloxacin Resistant Strains and Sensitive Strains Drug Resistance Analysis

目的比较临床感染肠杆菌科细菌环丙沙星耐药菌株与环丙沙星敏感菌株的耐药性差异，为临床合理选用有效抗菌药物提供参考。方法对贵州医科大学第三附属医院2011年6月-2014年11月临床感染标本中分离出2073株肠杆菌科细菌，分为环丙沙星耐药菌株组和环丙沙星敏感菌株组，采用VITEK-32分析鉴定系统进行病原菌鉴定，抗菌药物药敏试验及其结果判断均采用美国临床实验室标准化协会（CLSI）推荐的K—B法及其结果判断标准，统计分析应用SPSS19．0软件。结果在2073株肠杆菌科细菌中肠杆菌科细菌环丙沙星耐药菌检出率达30．39％（630／2073）；分离出的630株耐环丙沙星肠杆菌科细菌对31种抗菌药物的药敏试验中有头孢唑林、氨苄西林／舒巴坦、头孢呋肟、妥布霉素和磺胺甲恶唑／甲氧苄啶等24种抗菌药物耐药率分剐为90．00％（567／630），83．02％（523／630），93．80％（591／630），75．87％（478／630）和87．46％（551／630）；肠杆菌科细菌耐环丙沙星菌株的耐药性较环丙沙星敏感菌株严重，除亚胺培南和美罗培南外两者耐药率比较差异均具有统计学显著性意义（x2=11．95～1762．21，P〈0．001～0．000）。结论临床感染肠杆菌科细菌耐环丙沙星菌株检出率不断上升，耐药性明显高于环丙沙星敏感菌株，表现为同时对多种抗菌药物高耐药。

Objective To compare the difference of drug resistance between ciprofloxacin resistant strains and sensitive strains of ciprofloxacin in clinical infection,and provide reference for clinical rational use of antibiotics. Methods 2 073 strains of Escherichia coli were isolated from clinical specimens from November 2014 to June 2011 in the Affiliated Hospital of Guizhou Medical University. Strains of ciprofloxacin resistant strains were divided into ciprofloxacin resistant strains and ciprofloxacin sensitive strains. VITEK-32 analysis was used to determine the pathogenic bacteria, and the results were used to determine the K-B method and the results were used to determine the standard of SPSS 19.0. Results In 2 073 strains of Enterobacteriaceae resistant to ciprofloxacin bacteria detection rate was 30.39% （630/2 073）; 630 strains of ciprofloxacin resistant Enterobacteriaceae bacteria to 31 kinds of antimicrobial susceptibility test with cefazolin,ampicillin/Shubatan, cefuroxime,tobramycin and sulfamethoxazole/trimethoprim 24 kinds of antimicrobial drug resistance rate was 90.00% （567/ 630）,83.02% （523/630）,93.80% （591/630）,75.87% （478/630） and 87.46% （551/630） ,respectively. Drug resistance of Enterobacteriaceae in ciprofloxacin resistant strains compared with ciprofloxacin susceptible strains, except imipenem and meropenem resistance rate between the difference was statistically significant statistical difference （X2= 11.95- 1762.21 ,P 〈0. 001-0.00）. Conclusion The detection rate of ciprofloxacin resistant strains in clinical infection is increasing, and the drug resistance was significantly higher than that of ciprofloxacin resistant strains.