某中医院246例尿道感染大肠埃希菌临床分布及耐药性分析

目的探讨尿路感染病原菌的分布特点及耐药性,为临床抗菌药物的使用提供依据。方法收集2009～2011年尿液标本中分离出的大肠埃希菌246株,用VITEK-32鉴定仪鉴定,药敏试验采用K-B纸片扩散法。结果 246株大肠埃希菌中超广谱β-内酰胺酶(ESBLs)菌株112株,阳性率高达45.5%。大肠埃希菌对亚胺培南、美洛培南、阿米卡星、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的耐药率小于20.0%;对头孢唑啉、氨苄西林、环丙沙星、头孢曲松和左氧氟沙星头孢曲松、哌拉西林的耐药率大于60.0%。产ESBLs菌株对常用的18种抗生素耐药性高于非产ESBLs菌株。结论临床尿液标本分离大肠埃希菌耐药率和耐药性逐年增强,临床医师应该重视病原菌的培养和药物敏感试验,根据药敏结果合理应用抗菌药物。

Distribution and resistance analysis of E. coli in Urinary Tract Infections in traditional Chinese medicine hospital

Objective To approach the distribution characteristic and drug resistance status in pathogens from infected urinary tract,in order to provide reference for the chinical application of drugs in our hospital. Methods 246 Escherichia coli strains isolated from urine samples were collected from January 2009 to December 2011,which were identified with VITEK-32 system. K-B methods were used to detected the drug resistance. Results 246 strains of Escherichia coli were detected and the positive rate of ESBLs-producing E. coli was 45.5 %. E. coli was sensitive to Imipenem,meropenem, Amikacin, piperacillin/tazobactam and Cefoperazone/salbactam and the antibiotic resistances were less than 20 %. E. coli was resistance to Cefazolin, ampicillin, ceftriaxone, ciprofloxacin, and levofloxacin and the antibiotic resistances were all over 60.0%. The resistance of 18 kinds of commonly used antibiotic in E. coli producing ESBLs was higher than that in E. coli no-producing ESBLs. Conclusion The antibiotic resistance of E. coli isolated from urinary tract infection was increased. Clinicians should pay attention to the changes in drug resistances of E. coli and prescribe the antibiotic correctly.