2011年至2015年耐亚胺培南大肠埃希菌临床分离株的耐药性分析

Antimicrobial resistance profiles of the imipenem- resistant Escherichia coli clinical isolates from 2011 to 2015

目的调查耐亚胺培南大肠埃希菌临床分离株的分布及对常用抗菌药物的耐药性。方法收集2011年1月至2015年12月温州医科大学附属第一医院从各种标本分离的10428株大肠埃希菌。常规方法进行细菌分离培养,用VITEK全自动微生物分析仪对大肠埃希菌进行菌种鉴定和药敏试验。结果 10428株大肠埃希菌临床株中,6538株菌产超广谱β内酰胺酶(ESBLs),占62.69%;84株对亚胺培南耐药,耐药率为0.81%。2011年至2015年大肠埃希菌对亚胺培南的耐药率分别为0.14%(2/1397株),0.47%(9/1898株),0.55%(12/2170株),0.88%(22/2489株),1.58%(39/2474株)。84株耐亚胺培南株中,42株为产ESBLs株,占50.00%。84株耐亚胺培南株对头孢唑啉、氨苄西林、氨苄西林/舒巴坦、厄他培南和头孢曲松等药物的非敏感率超过90.00%;对呋喃妥因和阿米卡星的敏感率超过50.00%,分别为50.00%和62.50%;对其他抗菌药物的敏感率均低于30.00%。结论亚胺培南仍对大肠埃希菌表现出较好的体外抗菌活性,但其耐药率有逐年增加的趋势。

Objective To investigate the distribution and antimicrobial resistance profiles of the imipenem- resistant Escherichia coli clinical isolates. Methods A total of 10428 Escherichia coli isolates were isolated from various specimens of patients at the first affiliated hospital of Wenzhou medical university from January 2011 to November 2015. The identification and antimicrobial susceptibility testing for Escherichia coli isolates were determined by VITEK Full Automated Microbiology Analyzer. Results Among 10428 Escherichia coli clinical isolates,including62. 69% ESBLs- producing isolates,84（ 0. 81%） were resistant to imipenem. The rates of imipenem resistance among Escherichia coli isolates from 2011 to 2015 were 0. 14%（ 2 /1397 strains）,0. 47%（ 9 /1898strains）,0. 55%（ 12 /2170 strains）,0. 88%（ 22 /2489 strains） and1. 58%（ 39 /2474 strains）. Among 84 imipenem- resistant isolates,50. 00%（ 42 /84 strains） were ESBLs- producing isolates; the non-susceptibility rates of all imipenem- resistant isolates to cefazolin,ampicillin,ampicillin / sulbactam,ertapenem and ceftriaxone were more than90. 00%. However,the susceptibility rates of these isolates to nitrofurantion and amikacin were more than 50. 00%（ 50. 00% and 62. 50%）.The susceptibility rates of imipenem- resistant isolates to other types of antibiotics were less than 30. 00%.Conclusion Imipenem has fine antimicrobial activity in vitro against Escherichia coli isolates. However, the prevalence of imipenem resistance among Escherichia coli clinical isolates is increasing year by year.