医院2020—2021年大肠埃希菌临床分布特征及耐药性分析

Analysis of clinical distribution characteristics and drug resistance of Escherichia coli in the hospital from 2020 to 2021

目的分析2020—2021年首都医科大学附属北京妇产医院大肠埃希菌临床分布特征及耐药情况。方法回顾性选取2020年1月至2021年12月于首都医科大学附属北京妇产医院分娩的150例大肠埃希菌阳性产妇。采用描述性流行病学方法对大肠埃希菌临床分布特征[患者年龄、标本来源、超广谱β内酰胺酶(ESBLs)检出情况]及耐药性进行分析。结果150例大肠埃希菌阳性产妇中,年龄31~40岁占比最高、为59.3%(89例),其次为21~30岁、占32.0%(48例),41~45岁最少、占8.7%(13例)。150份大肠埃希菌阳性标本中,胎盘子面拭子占比最高、为66.7%(100份),其次为胎盘母面拭子和新生儿咽拭子,分别占55.3%(83份)和52.7%(79份)。共97例(64.7%)产妇存在多部位感染。ESBLs阳性菌株占32.0%(48/150)。ESBLs阳性大肠埃希菌对头孢呋辛、头孢曲松、哌拉西林、环丙沙星、氨苄西林的耐药率较高(耐药率>80.0%),对头孢替坦、头孢吡肟、哌拉西林/他唑巴坦、妥布霉素、美罗培南、亚胺培南、阿米卡星的耐药率较低(耐药率<10.0%)。结论本院产妇大肠埃希菌主要来源于胎盘子面拭子、胎盘母面拭子、新生儿咽拭子,且存在多重部位感染。ESBLs阳性检出率较高,对多种抗菌药物均有较高的耐药性。

Objective To analyze clinical distribution characteristics and drug resistance of Escherichia coli in Beijing Obstetrics and Gynecology Hospital,Capital Medical University from 2020 to 2021.Methods From January 2020 to December 2021,150 maternities with positive Escherichia coli delivered in Beijing Obstetrics and Gynecology Hospital were enrolled retrospectively.Descriptive epidemiological method was used to analyze the clinical distribution characteristics[patient age,specimen source and detection of extended spectrumβ-lactamases(ESBLs)]and drug resistance of Escherichia coli.Results Among 150 cases of maternities with positive Escherichia coli,the highest proportion of age distribution was in 31-40 years old,accounting for 59.3%(89 cases),followed by 21-30 years old,accounting for 32.0%(48 cases),and patients aged 41-45 years old were the least,accounting for 8.7%(13 cases).Among 150 cases of positive Escherichia coli samples,the rate of placental fetal swabs was the highest,accounting for 66.7%(100 cases),followed by placental maternal swabs and neonatal pharyngeal swabs,accounting for 55.3%(83 cases)and 52.7%(79 cases),respectively.A total of 97 cases(64.7%)of maternities had multiple site infection.Positive ESBLs strain accounted for 32.0%(48/150).The drug resistance rates of ESBLs positive Escherichia coli to cefuroxime,ceftriaxone,piperacillin,ciprofloxacin and ampicillin were high(drug resistance rate>80.0%),and the resistance rates to cefotetan,cefepime,piperacillin/tazobactam,tobramycin,meropenem,imipenem and amikacin were low(drug resistance rate<10.0%).Conclusion Escherichia coli mainly comes from placental fetal swabs,placental maternal swabs and neonatal pharyngeal swabs in maternities in the hospital,and there are multiple site infections.The positive detection rate of ESBLs is high,and it has high resistance rate to a variety of antibiotics.