某院伤口感染ESBLs大肠埃希菌耐药性及危险因素分析

Analysis of drug resistance and risk factors of ESBLs-producing Escherichia coli in wound infections

目的研究伤口感染产广谱β-内酰胺酶大肠埃希菌的耐药性及其危险因素。方法采用回顾性研究方法,对某医院住院患者伤口分泌物分离产广谱β-内酰胺酶(ESBLs)大肠埃希菌耐药性及其引发伤口感染的危险因素进行调查与分析。结果从该医院住院患者送检伤口分泌物标本中分离出大肠埃希菌116株,其中产ESBLs菌株49例,占分离大肠埃希菌总数的42.24%。产ESBLs菌株对多数常用抗菌药物的耐药率高于非产ESBLs菌株(P<0.05)。多因素分析结果显示,多发伤、多次清创、混合感染、使用三代头孢菌素、住院时间>30 d等因素构成产ESBLs大肠埃希菌伤口感染的独立危险因素。结论伤口感染产ESBLs大肠埃希菌耐药严重,应采取有效的防控措施,防止耐药菌的流行和播散。

Objective To investigate the drug resistance of extended-spectrumβ-lactamases-producing Escherichia coli and its risk factors in wound infections.Methods A retrospective study was conducted to investigate and analyze the drug resistance of extended-spectrumβ-lactamases(ESBLs)-producing Escherichia coli isolated from wound secretions in inpatients of a hospital and the risk factors of wound infections.Results 116 strains of Escherichia coli were isolated from the wound secretion specimens of the hospital inpatients,of which 49 were ESBLs-producing strains,accounting for42.24%of the total isolates of Escherichia coli.The resistance rates of ESBLs-producing strains to most commonly used antibacterial drugs were significantly higher than that of non-ESBLs-producing strains(P<0.05).Multivariate Logistic regression analysis showed that multiple injuries,multiple debridements,mixed infections,use of third-generation cephalosporins,hospital stays>30 d were independent risk factors for wound infection of ESBLs-producing Escherichia coli.Conclusion ESBLs-producing Escherichia coli originated from wound infection has serious drug resistance,and effective prevention and control measures should be taken to prevent the prevalence and spread of drug-resistant bacteria.