1526株大肠埃希菌感染的临床分布及耐药性监测

目的分析该院连续5年大肠埃希菌的感染分布及耐药性特点,为临床预防控制和治疗大肠埃希菌感染提供实验室依据。方法收集该院2008—2012年临床分离的大肠埃希菌,采用纸片扩散法（K-B）进行药敏试验,资料用WHONET5.6软件进行统计分析。结果 5年中共分离出1 526株大肠埃希菌,在尿液标本（33.6%）中检出最多,科室分布以普外科（24.2%）、泌尿外科（17.2%）和急诊科（13.8%）为主;其中ESBLs阳性率51.8%,产ESBLs菌株对大多数抗菌药物的耐药率明显高于非产ESBLs菌株（P〈0.01）;检出3株（0.2%,3/1526）碳青霉烯类抗生素耐药的大肠埃希菌。结论该院大肠埃希菌对抗菌药物呈现不同程度的耐药,碳青霉烯类抗生素仍是活性最高的药物,但已经出现耐药菌株,应加强耐药性监测,防止其在医院内的流行。

Clinical distribution and surveillance of bacterial resistance of 1 526 strains of escherichia coli

Objective To provide references for control and therapy of infection by analyzing the distribution and drug resistance of escherichia coli in five consecutive years. Methods escherichia coli was collected in our hospital from 2008 to 2012. Antimicrobial susceptibility test was conducted by Kirby-Bauer method. The data were analyzed by WHONET 5. 6. Results In five years,1526 strains of escherichia coli were isolated,the majority of which were isolated from the specimen of urine（ 33. 6%）. The bacteria was mainly distributed in general surgery（ 24. 2%）,urology（ 17. 2%） and emergency department（ 13. 8%）. The positive rate of ESBLs was 51. 8%. The ESBLs-producing strains to most of the drugs were significantly more resistant than the corresponding non-ESBLs-producing strains（ P ＆lt; 0. 01）. The carbapenem-resistant escherichia coli（ 0. 2%,3 /1526） were identified. Conclusions escherichia coli presents various degrees of resistance to antimicrobial agents. Carbapenems remains to have the highest activity against escherichia coli, but carbapenem-resistant escherichia coli has appeared. It is necessary to strengthen the surveillance to prevent the spread of the drug resistance.