摘要
目的调查某院大肠埃希菌的临床分布及对抗菌药物的耐药性变化趋势,指导临床合理用药。方法回顾性分析某院2013~2016年间常规分离培养出的732株非重复大肠埃希菌菌株的标本来源、科室分布及抗菌药物耐药性,K-B纸片法进行药敏试验,采用Whone 5.6软件进行药敏统计分析,采用SPSS 19.0软件进行数据统计处理。结果 2013~2016年间各年分别分离出大肠埃希菌216株、188株、196株、132株,标本主要来源于痰液(290株,39.6%)、尿液(221株,30.2%)和血液(95株,13.0%);科室主要分布在儿科(152株,20.8%)、结核病区(119株,16.3%)、肝病区(93株,12.7%)和感染病区(81株,11.1%);产ESBLs菌株共363株(占49.6%),主要分布在肝病区、感染病区、结核病区;产ESBLs大肠埃希菌耐药率明显高于非产ESBLs大肠埃希菌(P<0.01)。732株大肠埃希菌对青霉素类药物耐药率最高,其次为头孢菌素类、喹诺酮类、氨基糖苷类(除阿米卡星)、单环内酰胺类、氯霉素以及磺胺类药物;对阿米卡星、头霉素类和β-内酰胺类/含酶抑制剂复合物(除氨苄西林/舒巴坦和阿莫西林/克拉维酸)的耐药率较低(≤30.0%),对亚胺培南和美洛培南耐药率分别为1.2%和1.0%。结论大肠埃希菌ESBLs的检出率及其对绝大部分抗菌药物的耐药率维持在较高水平,治疗产ESBLs大肠埃希菌的感染,应首选含酶抑制剂和头霉素类药物,并可联合阿米卡星,重症感染可选用碳青霉烯类药物。
Objective To investigate the distribution and trends of drug resistance of escherichia coli （E.coli） in a hospital,so as to guide rational use of drugs in clinical practice.Methods The specimen source,distribution and antimicrobial resistance of 732 strains of non repetitive E.coli normally isolated from 2013 to 2016 in a hospital were analyzed retrospective- ly.And then, drug sensitivity test was performed by K-B method, drug sensitivity was analyzed by Whone 5.6 software, and all the data were statistically analyzed by SPSS 19.0 statistical software.Results A total of 732 non repetitive E.coli strains were isolated between 2013 - 2016 , with 216 strains, 188 strains, 196 strains and 188 strains for each year,respectively.Most of the strains were isolated from sputum （ 290 strains, 39.6% ） , urine （ 221 strains, 30.2% ） and blood （ 95,13.0% ） , and mainly distributed in the pediatric department （ 152 strains, 20.8% ）, tuberculosis （ TB ） department （ 119 strains, 16.3% ）, hepatology department （ 93,12.7% ） and infection department （ 81,11.1% ） .The ESBLs-producing strains （ 363,49.6% ） mainly distributed in hepatologiea] ward area, infectious ward area and tuberculosis ward area.The drug resistance rate of the ESBLs-produ- cing E.coli was significantly higher than that of the non-ESBLs-produeing E.coli （P〈0.01）.732 E.coli strains showed the highest resistant rate to penicillin, followed by cephalosporins, quinolone, aminoglycoside （excepted amikacin）, monobactams, chloramphenicol and sulfonamides. And the resistant rates to amikacin, cephamycins and β-1actams/β3-1actamase inhibitor complexes （excepted ampicillin/sulbactam and amoxicillin/clavulanic acid） were comparatively low （ ≤30.0% ）. In addition, the resistance rates to imipenem and meropenem were 1.2% and 1.0% ,respectively.Conclusion The detection rate of E.coli ESBLs and its resistance to most antibiotics remain a high levels.The inhibitors-containing complexes and cephamycins can be selected
作者
张文萍
张秋萍
叶飞娣
赖文杰
张仲明
陈珊
黄莎莎
单万水
ZHANG Wenping ZHANG Qiuping YE Feidi IAI Wenjie ZHANG Zhongming CNEN Shan HUANG Shasha SHAN Wanshui(Department of Clinical Laboratory, The Third People＇ s Hospital of Shenzhen Affiliated to Guangdong Medical University, Shenzhen 518114, China Department of Obstetrics and Gyneeology,Luohu District Maternal and Child Health Care Hospital of Shenzhen , Shenzhen 518019, China)
出处
《右江医学》
2017年第3期294-298,共5页
Chinese Youjiang Medical Journal
基金
深圳市科技计划项目(JCYJ20150402111430615)
深圳三名工程
深圳市生物芯片研究重点实验室(ZDSYS201504301534057)
