产超广谱β-内酰胺酶大肠埃希氏菌耐药谱分析

目的调查产超广谱β-内酰胺酶(ESBLS)大肠埃希氏菌临床分离株近年来耐药谱的变化。方法应用回顾性调查分析方法对该期间临床标本分离的大肠埃希氏菌产与非产ESBLs菌株的培养和药敏数据进行对比统计分析。结果所分离出的大肠埃希氏菌454株中ESBLs阳性201株,占43.4%,呈逐年升高的趋势,产ESBLs的大肠埃希氏菌对青霉素类、头孢菌素类、单环β-内酰胺类、氨基糖苷类、喹诺酮类以及加β-内酰胺酶抑制复合抗生素如氨苄西林/舒巴坦、阿莫西林/克拉维酸、替卡西林/克拉维酸等抗菌药敏呈多重耐药,显著高于非产ESBLs的菌株(P<0.001),但对亚胺培南高度敏感。结论本地区大肠埃希氏菌产ESBLs的阳性率高,耐药性日趋严重,临床治疗中应严格掌握抗菌药物应用指征,防止产ESBLs大肠埃希氏菌的局部流行。

Analysis on Drug Resistance Pattern of Extended-Spectrum β-Lanctamase Producing Escherichia Coli

Objective To investigate recent changes of drug resistance pattern of clinically isolated extended-spectrum β-lactamases(ESBLs) producing Escherichia coli(E.coli).Method E.coli were isolated from clinical samples,and the data of culture and drug sensitivity in either ESBLs producing or non-producing strains were analyzed retrospectively.Results In 454 strains of E.coli,201 strains were ESBLs positive(43.4%).The elevated mode by years was found.ESBLs-producing strains displayed drug resistance to penicillins,cephalosporins,monbactams,aminoglycoside,quinolones and ampicillir/sulbactam,amoxicillin/clavulanic acid,et al.The resistance was significantly higher than that of ESBLs non-producing strains(P<0.001).But both of them were highly sensitive to imipenem.Conclusions The positive rate of ESBLs producing E.coli in our area is high and drug resistance is severe gradually.In order to prevent the infection outbreak of ESBLs producing E.coli,more sputum culture and drug sensitivity should be emphasized before medication.