摘要
目的对老年人群泌尿系感染大肠埃希菌的抗菌药物耐药情况进行分析,用于指导临床合理用药。方法回顾分析2011年8月至2014年7月60岁以上泌尿系感染住院患者样本837例,采用ATB细菌鉴定药物敏感性分析仪进行细菌鉴定,并对17种抗菌药物及联合用药方案进行药物敏感性测试,采用2010年美国临床实验室标准化协会(CLSI)标准进行判别,WHONET 5.4软件分析病原菌的分布及耐药情况。结果大肠埃希菌对亚胺培南及美罗培南的敏感率均为100%;对阿米卡星、阿莫西林-克拉维酸及哌拉西林-克拉维酸均保持较高的敏感性(耐药率<17.0%);对头孢西丁及奈替米星较为敏感(耐药率约为30.0%);对庆大霉素、妥布霉素、复方磺胺甲口恶唑、替卡西林-克拉维酸及第2代到第4代头孢类抗菌药物的敏感性较低(耐药率>49.0%);对青霉素类、第1代头孢菌素及环丙沙星几乎不敏感(耐药率>83.0%)。3个统计年度的超广谱β-内酰胺酶(ESBLs)阳性菌株呈上升趋势,但差异无统计学意义(P>0.05)。结论大肠埃希菌对不同抗菌药物的耐药性不同,这为临床个性化医疗服务奠定了基础。
Objective To analyze the drug resistance of Escherichia coli isolated from urinary tract infection in elder patients,in order to give a reference for the reasonable selection of antibiotics in clinical treatment. Methods From August 2011 to July 2014,a retrospective analysis was undergone regarding the drug resistance of Escherichia coli isolated from urinary tract infection in 837 elder inpatients（ above 60 years old）. A total of 17 kinds of antibiotics were determined singly or combinedly for their antimicrobial susceptibility. The drug resistance was analyzed according to the standard of the Clinical and Laboratory Standards Institute（ CLSI） issued in 2010. WHONET 5. 4 software was used in datum analysis. Results Escherichia coli was 100. 0% sensitive to imipenem and meropenem. A significant sensitivity was observed for amikacin,amoxicillin-clavulanic acid and piperacillin-clavulanic acid（ drug resistance rate 〈 17. 0%）,whereas a considerable sensitivity was observed for cefoxitin and netilmicin（ drug resistance rate was 30. 0%）. Less sensitivity was found for gentamicin,tobramycin,compound sulfamethoxazole,ticarcillin-clavulanic acid and the 2nd to4 th generations of cephalosporin antibiotics（ drug resistance rate 〉 49. 0%）. Penicillins, the 1st generation of cephalosporin and ciprofloxacin were almost inactive to Escherichia coli（ drug resistance rate 〉 83. 0%）. Extendedspectrum beta-lactamases（ ESBLs）-producing isolates were found with increasing trend regarding 3 statistical years,but there was no statistical significance（ P 〉 0. 05）. Conclusions Escherichia coli displays different levels of drug resistance to different antibiotics. It may hold as a basis in the individual clinical treatment to patients.
出处
《检验医学》
CAS
2015年第12期1206-1209,共4页
Laboratory Medicine
关键词
大肠埃希菌
耐药性分析
泌尿系感染
老年患者
Escherichia coli
Drug resistance analysis
Urinary tract infection
Elder patient
