泌尿外科尿路感染患者大肠埃希菌产超广谱β-内酰胺酶的检出率与抗菌药物使用的相关性分析

Analysis on Correlation Between Detection Rate of ESBLs-producing E.coli and Usage of Antibacterials in Patients with Urinary Tract Infection in Urology Surgery

目的:探究医院泌尿外科患者尿培养中大肠埃希菌产超广谱β-内酰胺酶(extended-spectrumβ-lactamases,ESBLs)检出率与抗菌药物使用的相关性,为减少ESBLs的检出及临床合理使用抗菌药物提供参考。方法:抽取医院泌尿外科2016年—2018年间收治的尿路感染患者321例尿培养结果资料,统计其大肠埃希菌产ESBLs检出率及该科同期抗菌药物使用DDDs数据,分析ESBLs检出率与DDDs的相关性。结果:321例尿路感染患者尿液标本中,检出大肠埃希菌321株,其中ESBLs检出170株(占52.96%)和耐碳青霉烯类菌株4株(占1.23%);检出的大肠埃希菌对大部分抗菌药物的耐药情况基本无明显波动,但部分抗菌药物受ESBLs影响,ESBLs对β-内酰胺类抗菌药物的敏感率与ESBLs检出率的改变具有一致性;经相关性分析结果提示ESBLs检出率与拉氧头孢DDDs呈显著负相关(r=-0.9200,P<0.01),而与其他抗菌药物DDDs间呈无明显相关性。结论:重视对抗菌药物使用的监督与管理,严格管控临床抗菌药物的合理使用,以确保患者用药的有效性,延缓或遏制细菌的耐药。

Objective:To investigate the correlation between the extended-spectrum-lactamase(ESBLs)and antimicrobials usage in the urine culture of hospital urology department patients and to provide reference for the reduction of ESBLs detection and the rational usage of antimicrobial agents in the clinical.Methods:The urine culture results of321 patients with urinary tract infection(UTI)admitted to the urology department of the hospital from 2016 to 2018 were collected,the ESBLs detection rate of Escherichia coli and the DDDs data of antibacterial drug usage in that department during the same period were counted,and the correlation between the ESBLs detection rate and DDDs was analyzed.Results:The 321 strains of Escherichia coli were detected in the urine samples of 321 patients with urinary tract infection,among which 170 strains of ESBLs accounted for 52.96%and 4 strains of carbapenems resistant strains accounted for 1.23%.The resistance of Escherichia coli detected to most antibacterial drugs showed no obvious fluctuation,but some antibacterial drugs were affected by ESBLs.The sensitivity of ESBLs to-moxalactam antibacterial drugs was consistent with the change of ESBLs detection rate.The results of correlation analysis indicated that the detection rates of ESBLs were negatively correlated with DDDs(r=-0.9200,P<0.01),but not significantly correlated with DDDs of other antibacterial drugs.Conclusion:Attention should be paid to the supervision and management of antimicrobial usage,and the rational usage of clinical antimicrobial drugs should be strictly controlled so as to ensure the effectiveness of drug medication for patients,and delaying or curbing the resistance of bacteria.