近6年产超广谱β-内酰胺酶大肠埃希菌耐药性动态观察分析

目的动态观察并分析我院2001年1月至2006年12月6年间产超广谱β-内酰胺酶（ESBLs）大肠埃希菌的检出率及耐药性变化，为临床准确合理地进行治疗提供依据。方法采用美国临床实验室标准化委员会或研究所（NCCLS／CLSI）推荐的纸片扩散确证法检测ESBLs，纸片扩散法做药敏试验，WHONET5．3分析软件对药敏试验进行统计，并对产和非产ESBLs菌株的药敏试验数据进行对比分析。结果1053株大肠埃希菌中ESBLs阳性共445株，占42．3％，且6年来阳性率逐年显著性增高。体外药敏试验结果显示，亚胺培南、头孢西丁、阿米卡星、哌拉西林－他唑巴坦、头孢哌酮－舒巴坦对产ESBLs大肠埃希菌有较好的抗菌活性。产ESBLs大肠埃希菌的耐药率明显高于非产ESBLs菌株，且具有多重耐药性。结论本院大肠埃希菌产ESBLs率逐年升高，治疗时应考虑首选亚胺培南、头孢西丁、阿米卡星、哌拉西林－他唑巴坦、头孢哌酮－舒巴坦。

Dynamic observation and analysis of antibiotic resistance of ESBLs-producing Escherichia coli isolate during last six years

Objective To investigate and analyse the isolation rate and antibiotic resistance rate of extended spectrum beta-lactamases（ ESBLs ） -producing Escherichia coli from January 2001 to December 2006 in our hospital for correct and reasonable use of antibiotics. Methods ESBLs were detected by the method recommended by National Committee for Clinical Laboratory Standards（NCCLS） or Clinical and Laboratory Standards Institute （CLSI）. The antibiotic susceptibility was tested by the Kirby-Bauer method and the data were analyzed by the software of WHONETS. 3. The antibiotic susceptibility test data in either ESBLs-producing or non-producing strains was analyzed comparatively. Results Of 1 053 strains of Escherichia coli,445 strains were ESBLs-producing Escherichia coli. The positive rate was 42.3% , and the elevated mode by years was shown. The antibiotic susceptibility tests in vitro showed that imipenem, eefoxitin, amikacin,piperacillin-tazobactam and cafoperazone-sulbactam were effective to ESBLs-producing Escherichia coli. The ESBLs-producing Escherichia coli displayed the multi-antibiotic resistance, and the drug resistance rate in ESBLs-producing strains was higher than that in non-producing strains. Conclusions The positive rate of ESBLs-producing Escherichia coli increased year by year in our hospital during last 6 years. Imipenem, cefoxitin, amikacin, piperacillin-tazobactam and cafoperazone-sulbactam are suitable for clinical treatment of infection caused by ESBLs-producing Escherichia coli strains.