大肠埃希菌血流分离株的耐药特点分析

目的 对大肠埃希菌血流分离株的耐药特点进行分析.方法 收集南昌大学第二附属医院2005年1月-2011年12月从血液分离的大肠埃希菌,使用全自动微生物分析仪对大肠埃希菌进行菌种鉴定和药敏试验,超广谱β-内酰胺酶(ESBLs)的检测采用双纸片扩散法；头孢哌酮/舒巴坦和美罗培南的药敏试验采用K-B法.结果 112株血液分离的大肠埃希菌主要来自肝胆疾病的患者,占22.3％,其次为泌尿系统疾病,占13.4％,血液系统疾病占9.8％；检出55株产ESBls菌株,检出率为48.2％；产ESBLs大肠埃希菌对抗菌药物的耐药率较高,对5种药物的耐药率＞50.0％,但也有5种被测抗菌药物的耐药率＜20.0％,所有被测菌株对亚胺培南和美罗培南全部敏感,对阿米卡星、哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的耐药率分别为7.3％、10.9％、10.9％,非产ESBLs株对8种被测抗菌药物的耐药率＜10.0％.结论 血液分离的大肠埃希菌主要来自患有肝胆疾病的患者,产ESBLs菌株检出率较高.

Antimicrobial resistance profiles of Escherichia colibloodstream isolates

OBJECTIVE To investigate the antimicrobial resistance profiles of Escherichia coli bloodstream isolates.METHODS The E.coli isolates were collected from blood from Jan.2005 to Dec.2011 at the Second Affiliated Hospital of Nanchang University.The identification and antimicrobial susceptibility of the tested E.coli isolates were determined by Full-Automated Microbiology Analyzer.Extended-spectrum β-lactamases(ESBLs) were determined by double disk diffusion.RESULTS A total of 112 isolates of E.coli were isolated from blood of the patients,among which the patients with liver and gut diseases accounted for 22.3%,the patients with urinary system diseases accounted for 13.4% and the patients with blood disorders accounted for 9.8%.The prevalence of ESBLs-producing strains(55 strains)was 48.2%.The prevalence of antimicrobial resistance among E.coli bloodstream isolates was relatively high,among which 5 antimicrobials were with more than 50.0% of resistance and 5 antimicrobials were with less than 10.0% of resistance;all tested isolates were susceptible to impenem and meropenem.The resistance rates of ESBLs-producing isolates to amikacin,piperacillin/tazobactum and cefoperazone/sulbactum were 7.3%,10.9% and 10.9%,respectively,the resistance rates of non-ESBLs-producing isolates to 8 tested antibiotics were less than 10.0%.CONCLUSION The majority of E.coli isolates are isolated from the bloodstream of the patients with hepatobiliary diseases,the detection rate of ESBLs-producing E.coli isolates is relatively high.