产超广谱β-内酰胺酶大肠埃希菌尿路感染易感因素及耐药分析

目的 探讨产超广谱β-内酰胺酶(ESBLs)大肠埃希菌尿路感染患者的易感因素及其对抗生素的耐药情况.方法 对我院从2003年至2005年治疗的26例尿培养为产ESBLs大肠埃希菌的尿路感染患者进行回顾性分析,并与非产ESBLs组122例进行比较性分析.结果 产ESBLs大肠埃希菌尿路感染患者88.5%先前应用过广谱抗生素、69.2%的患者尿路存在复杂因素、42.3%接受过侵袭性操作;产ESBL5大肠埃希菌株对第2、3代头孢菌素、喹诺酮类耐药率明显高于非产ESBLs组,但对亚胺培南高度敏感.结论 产ESBLs大肠埃希菌耐药性日趋严重,应重视对尿路感染病原菌的ESBLs检测,并根据药敏合理应用抗生素.

Analysis of predisposing factors and drug resistance of urinary tract infection with extended-spectrum beta-lactamase producing Escherichia Coli

Objective To investigate the predisposing factors of urinary tract infection(UTI) with extendedspectrum beta-lactaraase(ESBLs) producing Escherichia Coli(E. coli) and its resistance to antimicrobial agents.Methods 26 cases of UTI patients with ESBLs producing E. coli from 2003 to 2005 in our hospital were analyzed retrospectively and compared with the ESBLs non-producing strains. Results 88.5 % of the patients with UTI in ESBLs producing E. coli had received broad-spectrum antimierobial therapy before the diagnosis, 69.2 % of the patients were complicate UTIS, 42.3 % of the patients experienced invasive operations in urinary tract; the incidence of drug resistance of ESBLs producing bacteria to the second, third-generation cephalosporins and quinolone was significantly higher than that of ESBLs non-producing bacteria, but it was highly sensitive to imipenem. Conclusion The drug resistance of ESBLs producing E. coli is severe gradually. So much attention should be paid to the ESBLs producing bacteria detection in UTIs. Antimicrobial therapy should be initiated under the guidance of drug sensitivity test,it is necessary to rid the predisposing factors of UITs as much as possible in order to decrease ESBLs-producing bacteria infection.