大肠埃希菌在泌尿系感染的筛查与耐药性分析

目的:了解泌尿系感染中大肠埃希菌对21种抗菌药物的耐药情况,为临床的合理用药提供参考。方法:用纸片扩散法(K-B法)对从门诊和住院泌尿系感染患者中分离的200株大肠埃希菌进行药物敏感试验分析,并用双纸片扩散法对产ESBLs菌株进行确证。结果:尿液标本中的大肠埃希菌对21种抗生素的耐药性检测结果显示,大肠埃希菌对舒普深、头孢西丁、亚胺培南、阿米卡星等单剂型药物的耐药性较低,其耐药率分别为8.7%、2.2%、2.2%、13.0%;对青霉素类和头孢菌素类抗生素的耐药率在60.0%以上;对复方磺胺的耐药率为91.3%;对四环素以及喹诺酮类抗生素的耐药率为65.2%～76.1%;对庆大霉素的耐药率为47.8%。对含ESBLs抑制剂的复合型抗生素的耐药率(阿莫西林/克拉维酸、哌拉西林/他唑巴坦为6.5%和2.2%)要明显低于单剂型同种抗生素。在46株大肠埃希菌中,产ESBLs菌株有20株,占43.5%,其对多种抗生素的耐药率显著高于不产ESBLs菌株。结论:引起泌尿系感染的大肠埃希菌耐药情况日趋严重,细菌耐药性监测对临床合理使用抗生素有指导意义。

Detection and Antibiotic Resistance Analysis of Escherichia Coli in Urinary Tract Infections

Objective:To investigate the drug resistance of Escherichia coli toward 21 different kinds of antibiotic in urinary tract infections,and to provide some advice with reasonable usage of antibiotic.Methods:K-B disc diffusion method was performed to detect the drug susceptibility of 46 strains of Escherichia coli isolated from patients with urinary tract infection and ESBLs-producing strains were confirmed.Results:The drug resistance tests of Escherichia coli from urine specimens showed its low resistance rates to sulbatam(8.7%),cefoxotin(2.2%),imipenem(2.2%)and amikacin(13.0%),while the resistance to other antibiotics was relatively high,including gentamicin(47.8%),penicinins and cephalosporins(both above 60.0%),tetracyclines and quinolones(from 65.2% to 76.1%)and sulfonamides(91.3%).The drug resistance rates to complex antibiotic containing inhibitors of extended-spectrum beta-lactamases were obviously lower than that of single-typed antibiotic.Among the total 46 strains of Escherichia coli,there were 20 ESBLs-producing strains,accounting for about 43.5%,and their drug resistance to many kinds of antibiotic was greatly higher than that of strains not producing ESBLs.Conclusion:The antimicrobial resistance of Escherichia coli which causes urinary tract infections was increasingly serious,minotoring drug resistances could direct rational usage of antibiotics.