不同时间段临床分离的大肠埃希菌的耐药性及分布

目的连续分析院内不同季度分离的大肠埃希菌的耐药性及分布,为临床经验治疗大肠埃希菌引起的感染提供理论依据。方法对2012年10月～2012年12月（2012年第4季度）、2013年1月～2013年3月（2013年第1季度）、2013年4月～2013年6月（2013年第2季度）和2013年7月～2013年9月（2013年第3季度）分别分离的213株、261株、236株和276株大肠埃希菌,用Walk Away 96 PLUS NC50药敏板检测菌株对亚胺培南等19种抗菌药物的耐药性,并对检测结果进行分析。结果 4个季度分离的大肠埃希菌对氨苄西林和四环素的耐药率均〉73%,对头孢唑啉、复方新诺明、环丙沙星、头孢夫辛和头孢噻肟的耐药率为52.9%～75.1%,对氨曲南、左氧氟沙星、头孢吡肟和庆大霉素的耐药率为42.9%～57.6%,对头孢他啶耐药率为33.0%～41.8%,对阿莫西林/克拉维酸、头孢西丁、阿米卡星、哌拉西林/他唑巴坦、亚胺培南、美罗培南和厄他培南的耐药率均〈23%。不同阶段分离的大肠埃希菌37.93%～48.31%的标本来源于尿液,15.25%～35.25%的标本来源于痰液,4.98%～13.15%的标本来源于血液。结论 2012年10月～2013年9月4个季度分离的大肠埃希菌对临床常用的多数抗菌药物的耐药率相差不大,各季度分离的大肠埃希菌主要引起泌尿道感染,其次是呼吸道和血流感染。

Analysis on the drug resistance and distribution of nosocomial Escherichia coli at different times

Objective To investigate the drug-resistance and specimen distribution of nosocomial Escherichia coli（E. coli） isolated in different quarters continuously, to provide the evidence for the clinicians to treat infections caused by E. coli on the basis of experience. Methods There were 213, 261, 236 and 276 strains of E. coli were isolated from October 2012 to December 2012（the fourth quarter of 2012）, January 2013 to March 2013（the first quarter of 2013）, April 2013 to June 2013（the second quarter of 2013） and July 2013 to September 2013（the third quarter of 2013）, respectively. Drug-resistances of the strains to 19 kinds of antimicrobial, including imipenem, were performed by Walk Away 96 PLUS NC50 susceptibility plates, and the test results were analyzed, respectively. Results Drug-resistance rates of E. coli isolated from the four quarters to ampicillin and tetracycline were all higher than 73%, and the drug-resistance rates to cefazolin, cotrimoxazole, ciprofloxacin, ceftazidime and cefotaxime were 52.9% to 75.1%. The drug-resistance rates to aztreonam, levofloxacin, cefepime and gentamicin were 42.9% to 57.6%, drug-resistance rates to ceftazidime was 33.0% to 41.8%. The drug-resistance rates to amoxicillin/clavulanic acid, cefoxitin, amikacin, piperacillin/tazobactam, imipenem, meropenem and ertapenem were all less than 23%. There were 37.93% to 48.31% of the E. coli isolated from different stages were obtained from urine, 15.25% to 35.25% of the samples were obtained from sputum, 4.98% to 13.15% of the samples were obtained from blood, respectively. Conclusions Drug-resistance rates of E. coli separated in the four quarters from October 2012 to September 2013 to the most antibacterial drug that commonly used in clinical had little difference. E. coli separated in each quarter mainly caused urinary tract infections, followed by respiratory and bloodstream infections.