天津地区某医院大肠埃希菌的耐药表型分布与耐药性研究

Drug resistance and its phenotype distribution of Escherichia coli in a hospital from Tianjin area

目的研究天津某三级医院住院患者细菌培养样本分离的大肠埃希菌其耐药表型分布及对常用抗生素的药敏结果。方法用VITEK 2 Compact对528株大肠埃希菌进行鉴定及药敏试验,用高级专家系统分析其耐药表型并修正抗生素结果。结果所有分离的菌株表型以野生型、CTX-M酶型超广谱β-内酰胺酶(ESBL)、高水平头孢菌素酶(Amp C)+ESBL、ESBL和耐酶抑制剂青霉素酶(IRT或OXA)为主。所有大肠埃希菌对氨苄西林耐药率最高,对美罗培南耐药率最低。耐药率超过50%的抗生素为氨苄西林、哌拉西林、头孢唑林、氨苄西林/舒巴坦、头孢呋辛、环丙沙星,其耐药率分别为87. 30%、58. 50%、56. 80%、55. 30%、52. 80%、52. 20%。结论 ESBL、Amp C和耐酶抑制剂青霉素酶是大肠埃希菌的主要耐药酶,该细菌对多种抗生素均有不同程度的耐药,建议临床感染病例应根据药敏试验结果选择抗生素。

Objective To analyze the distribution of drug-resistant phenotypes of Escherichia coli isolated from bacterial culture samples of hospitalized patients in a tertiary hospital in Tianjin and the drug susceptibility results of commonly used antibiotics.Methods A total of 528 strains of Escherichia coli were identified and tested for drug susceptibility using VITEK 2 Compact.The drug-resistant phenotype was analyzed and corrected by an advanced expert system.Results All isolated strain phenotypes were Wild-Type,CTX-M Extended-SpectrumΒ-Lactamase(ESBL),HL Cephalosporinase(Amp C)+ESBL,ESBL and Inhibitor resistant pase(IRT OR OXA).All Escherichia coli had the highest resistance rate to ampicillin and the lowest resistance to meropenem.The antibiotics with more than 50%resistance rate were ampicillin,piperacillin,cefazolin,ampicillin/sulbactam,cefuroxime,and ciprofloxacin.The resistance rates were respectively 87.30%,58.50%,and 56.80%,55.30%,52.80%,52.20%.Conclusion ESBL,Amp C and enzyme resistance inhibitor are the main resistant enzymes of Escherichia coli.The bacteria have different degrees of resistance to various antibiotics.It is recommended that clinical infections should be based on the results of drug susceptibility test.