2014-2019年大肠埃希菌感染流行病学调查及耐药性分析

Epidemiological investigation and drug resistance analysis of Escherichia coli infection from 2014 to 2019

目的了解2014—2019年医院大肠埃希菌感染流行病学特征及耐药情况。方法对2014—2019年医院分离出的1999株大肠埃希菌标本类型、科室来源、感染部位、人群特征进行分析。采用趋势χ2分析年际间医院大肠埃希菌分离率及大肠埃希菌对常见抗菌药物耐药率的变化趋势。结果2014—2019年医院大肠埃希菌分离率呈逐年下降趋势(P<0.05);2014—2019年医院大肠埃希菌检出率标本类型以尿液(52.43%)为主,科室以泌尿外科(25.66%)为主,感染部位以泌尿道(50.08%)为主,人群以<65岁(51.63%)和女性(56.43%)为主;大肠埃希菌对氨苄西林、哌拉西林、头孢曲松、左氧氟沙星、复方新诺明耐药率较高;2014—2019年间,大肠埃希菌对氨苄西林、哌拉西林、头孢曲松耐药率呈逐年上升趋势(χ2趋势=16.345,χ2趋势=10.697,χ2趋势=7.324,P<0.05)。结论2014—2019年医院大肠埃希菌分离率呈逐年下降趋势,但大肠埃希菌对氨苄西林、哌拉西林、头孢曲松耐药率有逐年上升趋势,临床在加强对高发部位、科室和人群监测的同时,还应做好药敏试验,指导临床合理用药。

Objective To investigate the epidemiological characteristics and drug resistance of Escherichia coli infection in Chengdu Second People′s Hospital from 2014 to 2019.Methods The specimen types,department sources,infection sites and population characteristics of 1999 strains of Escherichia coli isolated from the hospital from 2014 to 2019 were analyzed.The trendχ2 was used to analyze the annual isolation rate of Escherichia coli and the change of the rate of Escherichia coli resistance to common antibacterial drugs.Results The isolation rate of Escherichia coli showed a downward trend year by year from 2014 to 2019(P<0.05).From 2014 to 2019,the specimen type with high detection rate of Escherichia coli in the hospital was mainly urine(52.43%),the department was mainly in urology(25.66%),the main infection site was in the urinary tract(50.08%),and the population was mainly those under 65 years old(51.63%)and females(56.43%).Escherichia coli showed high drug resistance to ampicillin,piperacillin,ceftriaxone,levofloxacin and cotrimoxazole.From 2014 to 2019,the resistance rate of Escherichia coli to ampicillin,piperacillin and ceftriaxone increased year by year(χ2 trend=16.345,χ2 trend=10.697,χ2 trend=7.324,P<0.05).Conclusion From 2014 to 2019,the isolation rate of Escherichia coli had a downward trend year by year,but the drug resistance rate of Escherichia coli to ampicillin,piperacillin and ceftriaxone showed an upward trend year by year.In addition to strengthening the monitoring of high-risk sites,departments and population,drug sensitivity tests should also be done to guide rational clinical use.