院内大肠埃希菌耐药性分析及分布

目的：了解院内大肠埃希菌对临床常用抗菌药物的耐药性及分布，为临床合理使用抗菌药物提供理论依据。方法应用WHONET 5.6软件对2012年1月至2012年12月本院临床分离的742株大肠埃希菌对亚胺培南等16种抗菌药物的耐药性及分布进行回顾性分析。结果742株大肠埃希菌对氨苄西林、复方新诺明、环丙沙星、头孢噻肟、妥布霉素、左氧氟沙星、庆大霉素、氨曲南、头孢吡肟、头孢他啶、替卡西林/克拉维酸、阿莫西林/棒酸、头孢西丁、阿米卡星、哌拉西林/他唑巴坦和亚胺培南的耐药率依次为89.1%（661/742）、66.7%（495/742）、64.2%（476/742）、61.5%（456/742）、54.7%（406/742）、53.8%（399/742）、52.2%（387/742）、50.4%（374/742）、48.4%（359/742）、36.3%（269/742）、33.7%（250/742）、25.3%（188/742）、15.5%（115/742）、8.1%（60/742）、6.1%（45/742）和0.4%（3/742）。本研究中43.7%标本来源于尿液、23.7%标本来源于痰液、11.1%标本来源于血液。科室分布情况：分别有18.1%和16.2%的标本来源于儿内科病房和泌尿内科病房。结论院内大肠埃希菌主要引起泌尿道和呼吸道感染，其次是血流感染。对临床部分常用抗菌药物的耐药性较高，临床医师应根据药敏试验结果合理选用抗菌药物。

Analysis of drug resistance and distribution of Escherichia coli in our hospital

Objective To investigate drug resistance and clinical distribution of Escherichia coli in our hospital, thus guiding rational clinical application of antibacterials. Methods Total of 742 stains of Escherichia coli were collected from January 2012 to December 2012, whose drug resistance to 16 antibacterials including imipenem and distribution were analyzed by WHONET5.6, retrospectively. Results Resistance rates of the 742 strains of Escherichia coli to ampicillin, SMZ-TMP, ciprofloxacin, cefotaxim, tenebrimycin, levolfoxacin, cidomycin, aztreonam, cefepime, ceftazidime, ticarcillin/clavulanic acid, amoxicillin/clavulanic acid, cefoxitin, amikacin, piperacillin/tazobactam and imipenem were 89.1%（661/742）, 66.7%（495/742）, 64.2%（476/742）, 61.5%（456/742）, 54.7%（406/742）, 53.8%（399/742）, 52.2%（387/742）, 50.4%（374/742）, 48.4%（359/742）, 36.3%（269/742）, 33.7%（250/742）, 25.3%（188/742）, 15.5%（115/742）, 8.1%（60/742）, 6.1%（45/742） and 0.4%（3/742）, respectively. Among these, 43.7%specimen were detected in urine, 23.7%in sputum and 11.1%in blood, while 18.1%were collected from paediatrics ward, 16.2%from urinary department of internal medicine ward. Conclusions Resistance rates of Escherichia coli to common antibacterials were relatively higher, which mainly cause urinary and respiratory tract infection, and secondly blood infection. So antibiotics should be chosen according to drug sensitive test in the clinical practice.