碳青霉烯类耐药大肠埃希菌出现后的大肠埃希菌耐药性监测

Surveillance of bacterial resistance of Escherichia coli after the emergence of carbapenem-resistant Escherichia coli

目的分析本院碳青霉烯类耐药大肠埃希菌出现后大肠埃希菌的临床分布及耐药性变化。方法对本院2013年-2015年临床分离的大肠埃希菌,采用纸片扩散法(K-B)进行药敏试验,资料用WHONET5.6软件进行统计分析。结果 3年中共分离出1 716株大肠埃希菌,在尿液标本(45.6%)中检出最多,科室分布以泌尿外科(18.1%)、普外科(15.3%)和急诊科(12.3%)为主;其中ESBLs阳性率为47.0%,碳青霉烯类耐药大肠埃希菌检出率为1.7%,碳青霉烯类耐药大肠埃希菌株对大多数抗菌药物的耐药率比产ESBLs菌株高。结论碳青霉烯类仍是最有效的药物,碳青霉烯类耐药大肠埃希菌出现后的大肠埃希菌耐药性未出现明显增高,部分药物的耐药率有一定的下降趋势。

Objective To analyze the clinical distribution and drug resistance of Escherichia coli after the emergence of carbapenem-resistant Escherichia coli.Methods Escherichia coli was collected in our hospital from 2013 to 2015.Antimicrobial susceptibility test was conducted by Kirby-Bauer method.The data was analyzed by WHONET 5.6.Results In the 3 years,1 716 strains of Escherichia coli were isolated,and the majority were isolated from the specimen of urine（45.6%）.The bacteria mainly distributed in urology（18.1%）,general surgery（15.3%） and emergency department（12.3%）;the positive rate of ESBLs was 47.0%,and the detection rate of CRECO was 1.7%;the CRECO strains to most of the drugs were more resistant than the corresponding ESBLs-producing strains.Conclusion Carbapenems are still the most effective drug,and there is no obvious increase in antimicrobial resistance of Escherichia coli after the emergence of carbapenem-resistant Escherichia coli,but some drug＇s resistance rate has a decreasing trend.