尿路感染大肠埃希菌耐药分析路感染大肠埃希菌耐药分析尿路感染大肠埃希菌耐药分析尿路感染大肠埃希菌耐药分析.doc

尿路感染大肠埃希菌耐药分析 闫 雳 ［作者单位］安徽省萧县人民医院 检验科，235200 ［摘要］目的：探讨尿路感染中大肠埃希菌的耐药性变迁，为临床合理用药提供试验依据。方法：对2008~2010年度尿标本检出的234份大肠埃希菌进行超广谱β-内酰胺酶（ESBLs）检测和药敏试验，并对药敏结果进行分析。结果：大肠埃希菌的产酶率呈增高趋势；药敏结果显示大肠埃希菌除对亚胺培南耐药率为0外，对其他常用抗菌药物均出现了不同程度的耐药性，且ESBLS(+)的细菌耐药率普遍高于ESBLs(-)细菌。结论：尿路感染的大肠埃希菌耐药现象严重，尤其是ESBLs(+)株，要不断加强耐药性检测，为临床合理用药提供参考。 ［关键词］ 尿路感染；大肠埃希菌；药敏试验；超广谱β-内酰胺酶 [中图分类号]R446.5 R378.2.1 [文献标识码] A The analysis of drug resistance of Escherichia coli in urinary tract infections Yan Li (Department of Clinical Laboratory,Xiaoxian Peoples Hospital,Xiaoxian Anhui 235200,China) \ [Abstract]Objective:To exploring the resistance changes of the Escherichia coli (E.coli) in urinary tract infection, and provid proofs about the reasonable use of drugs in clinic.Methods：–foue strains of E.coli in 2008 to 2010 annual urine specimen with extended-spectrum β-lactamase (ESBLs) detection and drug susceptibility test,were detected,,and the drug susceptibility results were analyzed..Results:the rate of enzy production of E.coli showed a rising trend;the drug sensitivity test shows that the resistance exists in normal antibiotics was in different dgrees expect for Imipenem,,and the rate of medical resisitance in ESBLs(+) bacteria was higher than in ESBLs(-).Conclusions:The resistant of urinary tract infection which caused by E. coli. ?especially in?ESBLs (+)?strains, is so serious. It should be strengthen in the detections of the medical resistance ,which provide the references for the clinicl rational drug use. [Keywords] urinary tract infection; Escherichia coli; susceptibility test; extended-spectrum β-lactamase; 大肠埃希菌是尿路感染中最常见的革兰阴性杆菌，近几年，由于不合理的应用抗菌药物造成该细菌的耐药性不断增强，特别是第三代头孢菌素的广泛应用，出现了大量产超广谱β-内酰胺酶(extended spectrum β-lactamases, ESBLs)的大肠埃希菌，而产ESBLs菌株不仅对第三代头孢菌素和氨曲南耐药，且对氨基糖甙类、喹诺酮类、磺胺类交叉耐药，这给临床选用合适的抗菌药物带来很大的困难[1-2]。为此，我们对我院2008~2011年度尿液标本中检出的234株大肠埃希菌进行耐药性分析和ESBLs检测，现作报道。 1 材料与方法 1.1菌株来源 2008~2010年我院门诊和住院患者尿液中分离的234株大肠埃希菌，剔除同一患者重复培养株。 1. 2 细菌鉴定和药敏试验 采用MicroScanWalk AWay-4