108例大肠埃希菌血流感染临床分布特点及药敏分析

Clinical distribution characteristics and drug susceptibility analysis of 108cases of Escherichia coli bloodstream infections

目的调查分析濮阳市安阳地区医院108例大肠埃希菌血流感染患者临床分布特点及药敏情况。方法收集2021-01-01-2021-12-31濮阳市安阳地区医大肠埃希菌血流感染患者病病例资料,分析患者就诊科室、基础疾病等一般资料,使用全自动微生物药敏分析仪VITEK2检测其抗菌药物敏感性,采用WHONET5.4软件对药敏结果进行分析,采用SPSS 21.0对数据进行统计学分析。结果大肠埃希菌血流感染患者科室分布以重症监护病房(ICU)23.14%(25/108)和血液科16.66%(18/108)为主;血培养大肠埃希菌中产超广谱β-内酰胺酶(ESBLs)菌株41.67%(45/108);产ESBLs大肠埃希菌对大部分抗生素耐药性均明显高于非产ESBLs大肠埃希菌,产ESBLs菌株较非产ESBLs菌株对头孢类抗生素、青霉素类、氨曲南抗菌耐药性差异有统计学意义,均P<0.01。结论濮阳市安阳地区医院大肠埃希菌血流感染常见于ICU与血液科,且产ESBLs率较高,对多种抗菌药物具有耐药性,临床应引起足够重视,治疗时应根据药敏结果选择抗菌药物。

Objective To investigate and analyze the clinical distribution characteristics and drug susceptibility of 108patients with Escherichia coli bloodstream infections in Anyang District Hospital of Puyang City.Methods Totally 108 strains of non-repetitive Escherichia coli isolated from blood culture in Anyang District Hospital of Puyang City from January 2021to December 2021were collected,and the case data of 108patients with Escherichia coli bloodstream infections were retrospectively analyzed,and the general data of department for treatment and basic diseases of patients were analyzed.The antimicrobial susceptibility was detected by automatic microbial drug susceptibility analyzer VITEK2,and WHONET5.4software was used to analyze the drug susceptibility results.SPSS21.0statistical software was used to analyze and calculate the data.Results The patients with Escherichia coli bloodstream infections were mainly distributed in intensive care unit(ICU)(23.14%,25/108)and department of hematology(16.66%,18/108)in the hospital.There were 41.67%extended spectrum beta-lactamases(ESBLs)-producing strains(45/108)in blood culture of Escherichia coli in the hospital.The drug resistance of ESBLs-producing Escherichia coli to most antibiotics were higher than non-ESBLs-producing Escherichia coli,and there was a statistically significant difference between ESBLs-producing strains and non-ESBLs-producing strains in terms of antimicrobial resistance to cephalosporins,penicillins and aztreonam(P<0.01).Conclusions Escherichia coli bloodstream infection is common in ICU and department of hematology of Anyang District Hospital of Puyang City,with high ESBLs production rate.Escherichia coli strains are resistant to a variety of antimicrobial drugs,which should be paid enough attention in clinic.It is necessary to select the antimicrobial drugs according to the results of drug susceptibility.