产超广谱β-内酰胺酶大肠埃希菌临床分布及耐药性分析_临床医学论文.docVIP

产超广谱β-内酰胺酶大肠埃希菌临床分布及耐药性分析_临床医学论文 产超广谱β-内酰胺酶大肠埃希菌临床分布及耐药性分析_临床医学论文 【摘要】 目的 了解汨罗市人民医院分离的大肠埃希菌临床分布和耐药特点，为临床合理用药和控制大肠埃希菌感染提供依据。方法 采用K-B 纸片法和VITEK22系统对分离的216株大肠埃希菌进行ESBLs检测和药敏分析。结果 216株大肠埃希菌标本来源，痰分离出80株（37.04 %），其次为尿液53株（24.54 %）、胆汁36 株（16.67 %）等；产ESBLs 大肠埃希菌阳性检出率为30.56%（66株）；产ESBLs大肠埃希菌耐药率明显高于非产ESBLs大肠埃希菌，对青霉素类、头孢菌素类、喹诺酮类、氨曲南耐药率较高，对头孢哌酮/舒巴坦和哌拉西林/他唑巴坦耐药率较低，对亚胺培南和美洛培南耐药率为零。结论 产ESBLs大肠埃希菌具有多重耐药性，要重视产ESBLs菌株的检测，治疗其所致感染时，需根据药敏结果合理选用有效抗菌药物。 【关键词】 大肠埃希菌 分布 耐药性 产超广谱β-内酰胺酶 ［Abstract］ Objective To get the message of the distribution and antibiotic resistance of Escherichia coli in our hospital，and provide reliable evidence for doctor to use antibiotic reasonably and control the infection of Escherihia coli.Methods A total of 216 strains of E.coli were detected with ESBLs and analysis of antimicrobial sus ceptibility by Kirby-Bauer disk and VITEK22 system.Results Among 216 strains of E.coli，80 strains were isolated from sputum，accounted for 37.04%；53 from urine，accounted for 24.54%；36 from bile，accounted for 16.67 %.ESBLs production rate of E.coli were 30.56%.The resistance of E.coli with ESBLs to most antibiotics was much higher than those without ESBLs.And E.coli demonstrated much higher resistant rate to penicillins，cephalosporins，quinolones，aztreonam and much lower to cefoperazone/sulbactam and piperacillin-tazobactam.No strains were found to be resistant to imipenem and meropenem.Conclusion ESBLs-producing E.coli is multi-drug resistant to antibiotic，we must pay attention to ESBLs detection，reasonable choice of antibiotic should be in term of result of antibiotic resistant test to cure the E.coli infection. ［Key words］ Escherichia coli；distribution；antibiotic resistance；ESBLs 近年来，随着广谱抗生素长期广泛的使用和大量介入性诊疗技术的发展，医院感染越来越严重。大肠埃希菌是医院感染重要致病菌，可以导致多部位感染，甚至败血症。产超广谱β-内酰胺酶（ESBLs）的肠杆菌科细菌的耐药问题已成为当前全球最重要的细菌耐药问题之一。大肠埃希菌是肠杆菌科产ESBLs的代表性细菌，其产ESBLs菌株日益增多。为探讨大肠埃希菌的临床分布及耐药趋势，对汨罗市人民医院2005年1月～2007年12月住院患者感染标本分离出的216株大肠埃希菌进行分析，现将结果报告如下。 1 材料与方法 1.1 菌株来源 （1）实验菌株:收集我院住院患者送检的痰液、尿液、血液、腹腔积液、胆汁、伤口分泌物等标