妇幼保健机构大肠埃希菌感染的临床分布及耐药性分析

Clinical distribution and drug resistance of Escherichia coli causing infection in maternal and child health care institutions

目的探讨大肠埃希菌在妇幼保健机构的临床分布与耐药性变迁,为感染控制及指导临床合理使用抗菌药物提供依据。方法采用回顾性分析法对2008年1月-2014年6月临床微生物实验室从各种临床标本中分离842株大肠埃希菌进行分类统计,对其标本来源、科室分布及耐药性进行分析,并对典型感染病例进行比较。结果大肠埃希菌标本主要来源于宫颈分泌物、咽拭子和血液,分别占52.9%、25.7%和3.4%;临床科室中以产科送检标本量最大;大肠埃希菌检出率呈上升趋势,并与标本量呈正相关,耐药性方面以新生儿重症监护室耐药菌株检出率最高;2例产褥期败血症检出的大肠埃希菌耐药率也相对较高。结论产科和新生儿科大肠埃希菌感染比例最高,且新生儿科多药耐药菌检出率较高,产褥期败血症检出的大肠埃希菌也具有很强的耐药性,这应该引起临床的足够重视。

OBJECTIVE To explore the distribution and drug resistance of Escherichia coli strains isolated from ma- ternal and child health care institutions so as to control infections and provide guidance for reasonable clinical use of antibiotics. METHODS By means of retrospective analysis, totally 842 strains of E. coli that were isolated from various clinical specimens in clinical microbiology laboratory from Jan 2008 to Jun 2014 were classified for statistics. The specimens sources, distribution of departments, and drug resistance were observed, and the typical cases of infection were compared. RESULTS Among the E. coli strains isolated from various specimens, 52.90% were isolated from cervical secretions, 25.7% were isolated from throat swab specimens, and 3.4% were isolated from blood specimens. Among the clinical department, the obstetrics department contributed to the largest volume of submitted specimens ; the isolation rate of the E. coli strains showed an upward trend and was positively correlated with the sample size. As for the drug resistance, the isolation rate of drug-resistant strains was the highest in neonatal intensive care unit; the drug resistance rate of the E. coli strains isolated from 2 cases of puerperal sepsis was relatively high. CONCLUSION The proportion of the E. coli causing infections is the highest in the obstetrics department and neonatology department, and the isolation rate of multidrug-resistant strains is relatively high in neo- natology department. The E. coli strains isolated from patients with puerperal sepsis are also highly drug-resistant, which should be attached great importance to.