非痰标本大肠埃希菌的分布及其耐药性变迁分析

Analysis of the Distribution of Escherichia Coli in Non-sputum Specimens and the Changes of Drug Resistance

目的探讨非痰标本大肠埃希菌的分布及其耐药性变迁。方法选取该院2018年1月—2020年12月742例患者的非痰标本分离到大肠埃希菌作为研究对象,观察大肠埃希菌标本来源及耐药性变迁分析。结果标本构成主要为尿液(54.18%)、血液(30.46%)、脓(7.82%)、引流液(2.56%)、分泌物(2.43%)、白带(1.89%)、其他(0.40%)。标本主要分布科室为内分泌科153例(20.62%),泌尿外科134例(18.06%),心内科91例(12.26%),ICU 36例(4.85%),呼吸内科42例(5.66%),感染科39例(5.26%),神经内科48例(6.47%),肿瘤科34例(4.58%),普外科53例(7.14%),急诊内科25例(3.37%),妇产科46例(6.20%)。2018、2019、2020年大肠埃希菌对氨苄西林、ESBL、头孢曲松、头孢唑啉、复方新诺明、环丙沙星、左旋氧氟沙星具有较高耐药性,其耐药性高于40%;对头孢他啶、头孢吡肟、妥布霉素、呋喃妥因、哌拉西林/他唑巴坦、头孢替坦、阿米卡星、亚胺培南、厄他培南耐药性低。结论非痰标本大肠埃希菌在内分泌科、泌尿外科、心内科等科室中较为常见,且具有较高耐药性,应加强监测,对患者实施药敏试验,便于选取适宜药物进行治疗。

Objective To explore the distribution of Escherichia coli in non-sputum specimens and the changes in drug resistance.Methods E.coli was isolated from non-sputum specimens of 742 patients in the hospital from January 2018 to December 2020 as the research object,and the source of E.coli specimens and the analysis of drug resistance changes were observed.Results The composition of the specimen was mainly urine(54.18%),blood(30.46%),pus(7.82%),drainage fluid(2.56%),secretions(2.43%),vaginal discharge(1.89%),and others(0.40%).The main distribution departments of the specimens were 153 cases(20.62%)in the department of endocrinology,134 cases(18.06%)in the department of urology,91 cases(12.26%)in the department of cardiology,36 cases in the ICU(4.85%),42 cases(5.66%)in the department of respiratory medicine,39 cases(5.26%)in the department of infectious diseases,48 cases(6.47%)in neurology,34 cases(4.58%)in oncology,53 cases(7.14%)in general surgery,25 cases(3.37%)in emergency medicine,46 cases(6.20%)in obstetrics and gynecology.In 2018,2019,and 2020,Escherichia coli has high resistance to ampicillin,ESBL,ceftriaxone,cefazolin,compound trimethoprim,ciprofloxacin,and levofloxacin,its drug resistance was higher than 40%.Low resistance to ceftazidime,cefepime,tobramycin,nitrofurantoin,piperacillin/tazobactam,cefotetan,amikacin,imipenem,and ertapenem.Conclusion Non-sputum specimens of Escherichia coli are common in endocrinology,urology,cardiology and other departments,and have high drug resistance.Monitoring should be strengthened,and drug sensitivity tests should be implemented on patients to facilitate selection of appropriate drugs for treatment.