1999～2002年某医院大肠埃希菌耐药谱的分析

目的了解1999年2月～2002年7月间某医院大肠埃希菌超广谱β-内酰胺酶(ESBLs)的发生率及其耐药性变化趋势, 为临床合理应用抗生素提供科学依据.方法细菌鉴定、药敏实验采用MicroScan WalkAway-40全自动微生物分析仪,ESBLs检测采用纸片确证试验.结果共分离出大肠埃希菌1 336株,以尿液标本所占比例最高,为68.1%;1999～2002年大肠埃希菌ESBLS的发生率分别为17.6%、24.5%、28.7%、26.7%.4年来亚胺培南和阿米卡星对大肠埃希菌保持较强的抗菌活性,其次为哌拉西林/他唑巴坦和头孢西丁,且从1999年的76%和54%,到2002年的93%和80%,呈逐渐上升趋势;环丙沙星、庆大霉素、妥布霉素、复方新诺明的敏感率低于45%.结论 4年来该院大肠埃希菌产ESBLs的检出率保持在较稳定的水平.对大肠埃希菌引起的感染治疗可选用亚胺培南、阿米卡星、哌拉西林/他唑巴坦和头孢西丁等.

Analysis of antibiotic resistance spectrum of Escherichia coli between 1999 and 2002 in a hospital

Objective To study and 2002 in a hospital, in order tion and antibiotic susceptibility with double disc. Results The incidence of ESBLs was 17.6% , the incidence of ESBLs in E. coli and the change of its resistance between 1999 to instruct clinical application of antibiotics reasonably. Methods The identificaof bacteria were determined by MicroScan WalkAway-40. ESBLs were confirmed highest distribution was in the urine with 68. 1% in 1 336 isolates of E. coli. The 24.5%, 28.7% and 26. 7% between 1999 and 2002 respectively. The susceptible rates of imipenem and amikacin were higher. The susceptible rates of piperacillin/tazobactam and cefoxitin had risen from 76% and 54% in 1999 to 93% and 80% in 2002. The susceptible rates of ciprofloxacin, gentamicin, tobramycin and sulfamethoxazole/trimethoprim were less than 45%. Conclusion The incidence rates of ESBLs in E. coli have retained stable in the hospital from 1999 to 2002. The choice of the treatment of infections caused by E. coli is imipenem, amikacin, piperacillin/tazobactam and cefoxitin.