川东地区某三甲综合医院血流大肠埃希菌感染分析

Analysis of Escherichia Coli Infection in Blood Stream of a Class A General Hospital in Eastern Sichuan

目的分析川东地区某三甲医院住院发热患者血液培养分离的大肠埃希菌耐药性及其血清降钙素原(procalcitonin,PCT)检测结果,为三甲医院的大肠埃希菌血流感染(blood stream infection,BSI)防控以及临床治疗提供依据与参考。方法选取达州市中心医院2021年1—12月住院发热患者5542例,并采集患者的血液标本进行细菌培养,包括大肠埃希菌体外药敏试验及其血清PCT检测,并进行分析。结果住院发热患者血液标本细菌培养出大肠埃希菌105株,未发现厄他培南、美洛培南的耐药菌株。大肠杆菌对亚胺培南耐药率1.92%、哌拉西林/他唑巴坦、阿米卡星耐药率<5.0%,对其它抗菌药物呈现不同的耐药性且呈多重耐药性。70例大肠埃希菌血流感染患者PCT检测结果显示,PCT<0.5 ng/mL总计10例,>10 ng/mL总计27例。结论住院发热患者的血液标本中分离出的大肠埃希菌呈多重耐药且占比极高,临床治疗应根据细菌体外药敏试验及耐药特点合理使用抗菌药物。

Objective To analyze the drug resistance of Escherichia coli isolated from blood culture of patients with fever in a class A hospital in eastern Sichuan and the detection results of procalcitonin(PCT)in serum,to provide the basis and reference for the prevention and control of Escherichia coli blood stream infection(BSI)and clinical treatment in the third class A hospital.Methods A total of five thousand five hundred and forty-two hospitalized patients with fever from January to December 2021 in Dazhou Central Hospital were selected,and their blood samples were collected for bacterial culture,including Escherichia coli in vitro drug sensitivity test and serum PCT detection,and analyzed.Results One hundred and five strains of Escherichia coli were cultured from blood samples of hospitalized patients with fever,and no drug-resistant strains of ertapenem and meropenem were found.The resistance rate of escherichiacoli to imipenem was 1.92%,piperacillin/tazobactam and amikacin drug resistance rate was<5.0%,and the other antibiotics showed different resistance and multiple resistance.PCT detection results of seventy patients with Escherichia coli blood stream infection showed that PCT<0.5 ng/mL in ten cases,and>10 ng/mL in twenty-seven cases.Conclusion Escherichia coli isolated from blood samples of hospitalized patients with fever showed multiple drug resistance and accounted for a very high proportion.Antibiotics should be used rationally in clinical treatment according to the in vitro drug sensitivity test and drug resistance characteristics of bacteria.