某医院临床分离大肠埃希菌分布及其耐药性变迁

Analysis on changes of clinical distribution and drug resistance of Escherichia coli in a hospital

目的了解医院临床分离大肠埃希菌分布及其耐药性变迁,以指导临床合理选择抗菌药物。方法通过细菌分离培养和药敏试验方法,对某医院患者送检病原学标本进行检测和分析。结果共收集该医院临床分离大肠埃希菌4 150株,尿液标本居首位,占59.4%;其次是痰液和血液,分别占17.7%和13.1%。临床分离的大肠埃希菌主要来自老年医学科、重症监护病房(ICU)和肾内科。检出产β-内酰胺酶(ESBLs)大肠埃希菌1 940株,占46.7%,分离率呈逐年增加趋势;检出耐碳青霉烯类大肠埃希菌63株,占1.5%。结论临床分离的大肠埃希菌中,产ESBLs菌株比较高且呈增长趋势,显示该菌耐药严重,应当依据药敏试验结果选择抗菌药物。

Objective To understand the changes in clinical distribution and drug resistance of Escherichia coli in a hospital,so as to provide basis for the clinical reasonable use of antibiotics. Methods Bacterial isolation and culture and drug sensitivity test were used to detect and analyze etiology specimens of patients. Results 4 150 strains of Escherichia coli were collected,the first isolated from urine accounted for 59. 4%,followed by sputum and blood,accounted for 17. 7% and13. 1%. The top three departments were geriatric medical disciplines,ICU and nephrology departments. Totally 1 940 strains of producing ESBLs Escherichia coli were isolated,accouted for 46. 7%. Separation rate was increasing year by year. Totally63 strains of carbapenene drug-resistant,accounted for 1. 5%. Conclusion Of clinical isolated Escherichia coli,ESBLs is relatively high and increasing,which shows that the bacteria is seriously resistant. And we should select antibiotics according to the results of drug sensitivity test.