摘要
目的了解磷霉素对尿路感染患者肠杆菌科细菌的敏感性,指导临床合理用药。方法对2016年1-9月医院尿路感染患者清洁中段尿标本进行培养,共分离出肠杆菌科病原菌678株,使用BD-phoenix-100对尿路感染患者中段尿分离肠杆菌科细菌进行鉴定和药敏试验及产超广谱β-内酰胺酶(ESBLs)的检测,磷霉素药敏试验采用纸片扩散法测定,结果按CLSI 2015年版标准判断;应用WHONET 5.6软件分析分离株的分布和耐药情况。结果共分离678株肠杆菌科细菌,以大肠埃希菌为主,共510株占75.2%;肠杆菌科细菌对磷霉素的敏感率为92.3%;大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌中产ESBLs检出率分别为41.4%、38.2%、6.1%;产ESBLs大肠埃希菌、肺炎克雷伯菌对磷霉素的敏感率分别为94.3%、9.5%。结论尿路感染病原菌以大肠埃希菌、肺炎克雷伯菌为主,磷霉素对尿路感染病原菌(包括产ESBLs细菌)具有较好的敏感性,可作为临床首选的经验用药。
OBJECTIVE To investigate the susceptibility of fosfomycin against Enterobacteriaceae isolates from patients of urinary tract infections,so as to provide evidence for reasonable use of antibiotics.METHODS A total of 678 Enterobacteriaceae strains were isolated from midstream urine samples of patients from Jan.2016 to Sep.2016.Identification,antimicrohial susceptibility extended-spectrum bata-lactamse (ESBLs) and ESBLs-production were tested also by BD-phoenix-100,and antimicrobial susceptibility of fosfomycin was tested by Kirby-Bauer method.The results were analyzed according to the breakpoints of CLSI 2015.The distribution and antimicrobial susceptibility of pathogens were analyzed by WHONET 5.6 software.RESULTS Totally 678 isolates were isolated and collected,which were mainly 510 strains of Escherichia coli,accounting for 75.2 %.The sensitive rates of Enterobacteriaceae isolates to fosfomycin was 92.3 %.The ESBLs were identified in E.coli(41.4%),Klebsiella pneumoniae(38.2%),and Proteus mirabilis (6.1%).The sensitive rates of ESBLs-production E.coli and K.pneumoniae to fosfomycin were respectively 94.3 % and 90.5 %.CONCLUSION The main uropathogens are Escherichia coli and K.pneumoniae.The uropathogens have high susceptibility to fosfomycin,including ESBLs-production E.coli and K.pneumoniae.Fosfomycin can be used as the first line agents for empiric therapy in clinical.
作者
田鹏鹏
朱丽莎
马青
艾彪
龙聪
TIAN Peng-peng ZHU Li-sha MA Qing AI Biao LONG Cong(The First Affiliated Hospital of Yangtze University, J ingzhou, Hubei 434000, Chin)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2017年第12期2664-2667,共4页
Chinese Journal of Nosocomiology
基金
湖北省卫生计生科研基金(WJ2016-Y-33)
关键词
磷霉素
尿路感染
肠杆菌科
超广谱Β-内酰胺酶
敏感性
Fosfomycin
Urinary tract infection
Enterobacteriaceae
Extended-spectrum bata-lactamse
Susceptibility