某医院大肠埃希菌连续6年耐药性监测分析

目的探讨2015—2020年某医院大肠埃希菌对常用抗菌药物的耐药性发展趋势,为抗菌药物的合理应用提供参考依据。方法采用VITEK 2 Compact进行大肠埃希菌鉴定和抗菌药物最低抑菌浓度(MIC)的测定,并通过WHONET 5.6软件对2015—2020年大肠埃希菌检出情况、标本来源、病区分布和耐药率等进行统计。结果共检出大肠埃希菌2376株(非重复菌株),主要来源于尿液标本(40.7%)和痰液标本(30.2%),以泌尿外科和普通外科患者比较多见,构成比分别为19.1%、17.7%。大肠埃希菌产超广谱β-内酰胺酶(ESBLs)的平均检出率为53.4%,对氨苄西林耐药率高达90.8%,对亚胺培南和厄他培南的耐药率为2.1%、0.9%,产ESBLs阳性菌株对多数抗菌药物的耐药率高于不产ESBLS菌株。2015—2020年间,大肠埃希菌对青霉素类、头孢菌素类、氨基糖苷类和磺胺类抗菌药物的耐药率呈下降趋势,对喹诺酮类和碳青酶烯类抗菌药物的耐药率呈上升趋势。结论6年间该综合医院临床分离大肠埃希菌对多数抗菌药物的耐药率呈现下降趋势,但耐药形势仍然不容乐观,要密切关注碳青霉烯类抗菌药物的耐药变化情况。坚持动态监测病原菌对抗菌药物的耐药发展趋势,有助于减缓耐药性的过快增长。

Supervise and Analysis of Escherichia coli Resistance in a Hospital for 6 Years

Objective To analyze the resistance of Escherichia coli to traditional antibiotics in a hospital from 2015 to 2020,and facilitate the rational application of antibiotics.Methods Antifungal assays and identify of Escherichia coli were performed by VITEK 2 Compact.The detection rate,source,distribution and resistance of Escherichia coli from 2015 to 2020 were statistics by WHONET 5.6.Results A total of 2376 strains were detected,mainly from urine(40.7%)and sputum(30.2%),Most of them are patients with urology and general surgery,with a ratio of 19.1%and 17.7%,respectively.We found that the rate of Extended-spectrumβ-lactamases(ESBLs)Escherichia coli was 53.4%,and the resistance to Ampicillin was as high as 90.8%.Imipenem and Ertapenem resistance were 2.1%and 0.9%.The ESBLs strains have higher resistance than others.From 2015 to 2020,the resistance rate of Escherichia coli to penicillins,cephalosporins,aminoglycosides,and sulfa antibiotics showed a downward trend,and the resistance rate to quinolones and carbapenem antimicrobials showed a upward trend.Conclusion In the past 6 years,the resistance of Escherichia coli in the general hospital showed a downward trend,but the resistance situation was still serious,so we should pay close attention to the changes of Carbapenem antibiotics resistance.It is helpful to slow down the rapid growth of drug resistance by constantly monitoring the development trend of antimicrobial resistance of pathogenic bacteria.