摘要
目的研究内分泌科患者大肠埃希菌感染现状及大肠埃希菌对临床常用抗生素的耐药性,为内分泌科患者大肠埃希菌感染的防治提供依据。方法收集本院2012年1月-12月内分泌科感染患者临床标本,分离出116株大肠埃希菌并进行鉴定,对产ESBLs大肠埃希菌进行确证试验;采用K-B纸片扩散法对大肠埃希菌进行药敏试验,根据美国临床实验室标准化委员会药敏试验标准2014版判读结果;采用PCR检测大肠埃希菌常见耐药基因。结果 116株大肠埃希菌中检出65株产ESBLs大肠埃希菌,占56.03%。产ESBLs大肠埃希菌株对临床常用的14种抗生素耐药程度依次为：哌拉西林90.77%,庆大霉素70.77%,卡那霉素69.23%,妥布霉素35.38%,阿米卡星12.31%,复方新诺明64.62%,头孢噻肟87.69%,头孢吡肟40.00%,头孢西丁13.85%,左氧氟沙星75.38%,环丙沙星69.23%,加替沙星16.92%,亚胺培南1.54%和美罗培南3.08%。产ESBLs大肠埃希菌TEM等耐药基因携带率为3.08%-90.76%,未检出OTA-2,OTA-51和NDM-1基因。讨论临床分离株产ESBLs大肠埃希菌对哌拉西林,头孢噻肟和左氧氟沙星耐药率〉75%,因此上述3种药物不宜用于治疗产ESBLs大肠埃希菌感染。亚胺培南和美罗培南虽然对大肠埃希菌具有良好的治疗效果,但应控制使用,避免产生碳青霉烯耐药菌。
Objective The current state of Escherichia coli infection in patients in Endocrinology and the antibiotic resistance of E.coli were studied in order to prevent and treat infection with E.coli. Methods Specimens were collected from patients in Endocrinology from January 2012 to December 2014.One hundred and sixteen strains of E.coli were isolated from those specimens.The isolated strains were identified with an automated microbial identification system,and ESBL-producing E.coli were subjected to a verification test.Drug sensitivity was tested using the Kirby-Bauer disk diffusion method,and results were judged in accordance with the 2014 guidelines of the Clinical and Laboratory Standards Institute（CLSI）.PCR was used to detect common genes that induce drug resistance in E.coli. Results Sixty-five strains of ESBL-producing E.coli were detected at a rate of 56.03%.ESBL-producing E.coli strains were tested for their resistance to 14 commonly used antibiotics.Resistance to piperacillin was 90.77%,resistance to gentamicin was 70.77%,resistance to kanamycin was 69.23%,resistance to tobramycin was 35.38%,resistance to amikacin was 12.31%,resistance to cotrimoxazole was 64.62%,resistance to cefotaxime was 87.69%,resistance to cefepime was 40%,resistance to cefoxitin was13.85%,resistance to levofloxacin was 75.38%,resistance to ciprofloxacin was 69.23%,resistance to gatifloxacin was 16.92%,resistance to imipenem was 1.54%,and resistance to meropenem was 3.08%. Conclusion ESBL-producing E.coli had resistance to piperacillin,cefotaxime,and levofloxacin of more than 75%,so these 3drugs should not be used to treat an infection with ESBL-producing E.coli.Imipenem and meropenem are effective in treating an infection with E.coli,but their use should be controlled to avoid producing carbapenem-resistant bacteria.
出处
《中国病原生物学杂志》
CSCD
北大核心
2015年第10期940-943,共4页
Journal of Pathogen Biology
关键词
内分泌科
大肠埃希菌
药敏试验
耐药基因
Endocrinology
Escherichia coli
drug resistance
drug sensitivity test
drug resistance genes
