大肠埃希菌临床感染的分布及耐药性分析

目的了解临床各种标本分离的大肠埃希菌的耐药特点及差异,为临床合理使用抗菌药物提供依据。方法 收集2008年1月-2009年12月从305位患者中分离自中段尿,呼吸道及分泌物等标本的大肠埃希菌,采用天地人微生物分析系统及相配套的药敏试验卡进行细菌鉴定及药敏测定,并统计比较各种不同标本所检出大肠埃希菌对抗菌药物的耐药率。结果共检出大肠埃希菌305株,其中中段尿检出121株,呼吸道88株,分泌物等96株。中段尿与呼吸道分离的大肠埃希菌对复方新诺明（85.12%,70.45%）、庆大霉素（67.77%,50.00%）、阿莫西林/克拉维酸（33.88%,60.23%）的耐药率差异均有统计学意义;中段尿与分泌物及其它分离大肠埃希菌对复方新诺明（85.12%,69.79%）、头孢他啶（37.19%,9.38%）、妥布霉素（42.15%,8.33%）、阿莫西林/克拉维酸（33.88%,15.62%）的耐药率差异均有统计学意义;呼吸道与分泌物及其它分离的大肠埃希菌对头孢他啶（43.18%,9.38%）、环丙沙星（73.86%,88.54%）、阿莫西林/克拉维酸（60.23%,15.62%）的耐药率差异有统计学意义。结论不同标本分离的大肠埃希菌对同一抗菌药物耐药率不同,治疗不同部位大肠埃希菌引起的感染,要考虑由于感染部位不同而产生的耐药性以及药物有效浓度的差异,临床应依据药敏结果合理使用抗菌药物。

Analysis on Clinical Infection Distribution and Drug Resistance of Eschericbia coil

Objective To investigate the antibiotic resistant characteristics and differences of Escherichia coli isolated from different clinical samples,and to provide the evidence for guiding rational use of antimicrobial agents. Methods Escherichia coli isolated from 305 patients’ mid-portion of urine,respiratory tract,and secretion from January,2008 to December,2009 was collected.Heaven-earth-man analytic system and matching susceptibility test cards were used to perform bacterial identification and detect antimicrobial susceptibility.The drug resistant rates of Escherichia coli isolated from different samples were compared and statistically analyzed. Results Totally 305 strains of Escherichia colis were detected,among which 121 were detected from mid-portion of urine,88 from respiratory tract,and 96 from secretions.Escherichia coli isolated from mid-portion of urine and respiratory tract showed statistically significant difference in drug resistance against cotrimoxazole(85.12%,70.45%),gentamicin(67.77%,50.00%),and amoxicillin/clavulanic acid(33.88%,60.23%).Escherichia coli isolated from mid-portion of urine and secretions showed statistically significant difference in drug resistance against cotrimoxazole(85.12%,69.79%),ceftazidime(37.19%,9.38%),tobramycin(42.15%,8.33%),and amoxicillin/clavulanic acid(33.88%,15.62%).Escherichia coli isolated from respiratory tract and secretions showed statistically significant difference in drug resistance against ceftazidime(43.18%,9.38%),ciprofloxacin(73.86%,88.54%),and amoxicillin/clavulanic acid(60.23%,15.62%). Conclusions Escherichia coli isolated from different samples has different drug resistant features.Treating different parts of infections caused by Escherichia coli should consider the different sites of infection and drug effective consistency arising from the different sites of infection,meanwhile,clinicians should rationally use antibacterials based on the results of drugs sensitivity.