摘要
目的:研究承德医学院附属医院大肠埃希菌的临床分布,分析其对常见抗菌药物的耐药性,为正确掌握细菌耐药的发展趋势、临床合理应用抗生素提供理论依据。方法:收集大肠埃希菌,采用美国临床和实验室标准协会(CLSI)推荐的表型确证实验,获得产超广谱β-内酰胺酶(ESBLs)大肠埃希菌。所有菌株的鉴定及药敏实验均由仪器VITEK2完成。结果:674株主要来源于尿标本45%,痰标本29.7%,血液标本14.3%,其他的脓液、胸腹水、分泌物等占11%。产酶菌株364株与非产酶菌株310株进行比较,对于统计分析的19种抗菌药物除亚胺培南、美罗培南、复方新诺明对比组间差异无统计学意义外,其他抗生素对比组间差异有统计学意义(P<0.01),产酶菌株对于氨苄西林、哌拉西林、氨苄西林/舒巴坦、哌拉西林/他唑巴坦、头孢唑林、头孢呋辛、头孢克肟、头孢他啶、头孢曲松、头孢噻肟、头孢吡肟、头孢西丁、阿米卡星、庆大霉素、环丙沙星、左氧氟沙星的耐药率明显高于非产酶菌株。结论:大肠埃希菌的耐药性已经很严重,尤其是产酶菌株的耐药率已经很高,应严格加强大肠埃希菌耐药性的监测,防止耐药菌株在院内传播和流行。
Objective To study the clinical distribution of Escherichia coli in the Affiliated Hospital of Chengde Medical College, analyze the drug resistance of common antibiotics, and provide a theoretical basis for the proper development of antibiotic resistance and clinical rational application of antibiotics. Methods Escherichia coli was collected, and the extended spectrum β -lactamase （ESBLs）-producing Escherichia coli was obtained by CLSI-recommended phenotypic confirmation. The identification and drug sensitivity test of all strains were performed by VITEK2. Results Eseherichia coli （674 strains） isolated from outpatients and inpatients in our hospital were mainly from urine samples （45%）, followed by 29.7% of sputum specimens, 14.3% of blood samples, and some other pus, pleural effusion and secretions accounted for 11%. The 364 strains of enzyme- producing strains were compared with 310 strains of non-enzyme-producing strains. For 19 antimicrobial drugs, there were significant differences in the contrast groups except imipenem, meropenem and cotrimoxazole, the resistance rates of enzyme-producing strains against ampicillin, piperacil, ampicillin/sulbactin, piperacillin/ tamazobatam, cefazolin, cefuroxime, ceftazine, ceftriaxone, ceftrixone, cefotaxime, cefpime, cefoxidine, amicacin, cefriamycin, macrocycline, salfloxacin and levofloxacin were higher than those of non-enzyme-producing strains （P〈0.01）. Conclusion The antibiotic resistance of Escherichia coli in our hospital is very serious, especially the resistance rate of the enzyme-producing strain is very high, and the drug resistance of Escherichia coli should be strictly strengthened to prevent the drug-resistant strains from spreading and popularizing in the hospital.
作者
闫妹姝
陶晓明
华正祥
宗春光
YAN Mei-shu;TAO Xiao-ming;HUA Zheng-xiang(Affiliated Hospital of Chengde Medical College,Chengde（067000）,China)
出处
《中国中西医结合外科杂志》
CAS
2018年第5期609-612,共4页
Chinese Journal of Surgery of Integrated Traditional and Western Medicine
关键词
超广谱Β-内酰胺酶
大肠埃希菌
耐药性
Extended spectrum β -lactamases
Escherichia coli
drug resistance
