2010-2012年思南地区大肠埃希菌的耐药性变迁

目的 探讨思南地区大肠埃希菌（ECO）的耐药性变迁,为临床经验用药提供依据.方法 对2010-2012年间我院临床标本按照《全国临床检验操作规程》（第3版）的方法进行培养,细菌鉴定和药敏分析采用HX-21细菌鉴定药敏分析仪,按照美国2010年CLSI判断标准进行.结果 2010年1月1日-2012年11月30日共分离出EC0323株,其中产ESBLs的检出率为22.0％.对于2012年分离的ECO,耐药率低于30％的药物有：头孢吡肟、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、阿米卡星、呋喃妥因.产ESBLs的ECO具有多药耐药性,对其耐药率低于30％的药物有：头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南、阿米卡星、呋喃妥因.2010年,ECO在总阳性菌株、革兰阴性杆菌和肠杆菌科菌株中的构成比依次为44.7％、60.2％和80.8％;2011年,构成比依次为：32.4％、41.8％和48.9％;而2012年,进一步下降为：28.7％、38.3％和44.6％.结论 思南地区ECO的耐药性呈上升趋势,产ESBLs的ECO的耐药性尤为突出;应加强产ESBLs的ECO的监测,合理使用抗菌药物.ECO构成比呈下降趋势显示了我院临床菌株的多样化.

Variations of drug resistance of escherichia coli at Sinan city during 2010-2012

Objective To investigate the variations of drug resistance of Escherichia coli （ECO） at Sinan city so as to provide evidences for clinical experiential medication. Methods Cultures were carried out according to National clinical Labo- ratory Operating Instructions （the third edition） for clinical specimens in our hospital during 2010 and 2012. Identifications and antimicrobial susceptibility tests were done by using HX - 21 analyzer according to criteria of Clinical and Laboratory Standard Institute of America （CLSI） 2010. Results 323 strains of ECO were isolated from January 1,2010 to November 30, 2012, with a rate of 22. 0% producing ESBLs. Cefepime, cefoperazone/sulbactam, piperacillin/tazobactam, imipenem, amikacin and nitrofurantoin were with rates of resistance below 30. 0% for ECO isolated in 2012. ECO producing ESBLs was multi-drug resistant, with resistance rates below 30. 0% for cefoperazone/sulbactam, piperacillin/tazobactam, imipenem, amikacin and nitrofurantoin. Constituent ratios were 44. 7%, 60. 2% and 80. 8% for ECO among total isolates, gram negative bacilli and enterobacteriaceae respectively, which were 32.4% , 41.8% and 48.9% in 2011 and 28.7% , 38.3% and 44. 6% in 2012. Conclusion Drug resistance of ECO is rising at Sinan city, especially for those producing ESBLs. Surveillance should be enhanced for ECO produ- cing ESBLs. The declined constituent ratios of ECO showed the diversity of strains in our hospital.