不同临床标本分离的大肠埃希菌耐药性分析

目的了解临床不同标本分离的大肠埃希菌的耐药特点及差异,以合理使用抗菌药物。方法收集2004年1月-2005年12月分离自中段尿、痰、分泌物标本的大肠埃希菌,采用VITEK全自动微生物鉴定药敏仪进行细菌鉴定及药敏测定,并统计比较不同标本所检出大肠埃希菌对抗菌药物的耐药率。结果共检出大肠埃希菌241株,其中中段尿检出128株,痰54株,分泌物59株。中段尿与痰分离的大肠埃希菌对复方磺胺甲唑、庆大霉素、阿莫西林/克拉维酸的耐药率差异均有显著性(均P<0.05);中段尿与分泌物分离的大肠埃希菌对复方磺胺甲唑、头孢他啶、妥布霉素、阿莫西林/克拉维酸的耐药率差异均有显著性(均P<0.05);痰与分泌物分离的大肠埃希菌对培氟沙星、替卡西林的耐药率差异均有显著性(均P<0.05)。结论不同标本分离的大肠埃希菌对同一抗菌药物耐药率不同,治疗不同部位大肠埃希菌引起的感染,要考虑由于感染部位不同而产生的耐药性以及药物有效浓度的差异,按照药敏结果合理、有效使用抗菌药物。

Analysis of antimicrobial resistance in Escherichia coli isolated from different clinical samples

Objective To investigate antimicrobial resistance of Escherichia coli isolated from different clinical samples,so as to guide the rational use of antimicrobial agents.Methods Strains of Escherichia coli isolated from urine,sputum,secretion samples from January 2004 to December 2005 were collected,bacterial identification and antimicrobial susceptibility tests were performed by VITEK automatic system,drug resistant rate of Escherichia coli isolated from different samples were compared statistically.Results Two hundred and forty-one strains of Escherichia coli were isolated,128 of which were from urine,54 from sputum,59 from secretion.There was significant difference in drug resistant rate of Escherichia coli isolated from urine and sputum between SMZco,gentamycin,amoxicillin/clavulanic(All P<(0.05));there was significant difference in drug resistant rate of Escherichia coli isolated from urine and secretion between SMZco,ceftazidime,tobramycin,amoxicillin/clavulanic(All P<(0.05));there was significant difference in drug resistant rate of Escherichia coli isolated from sputum and secretion between pefloxacin and ticarcillin(both P<(0.05)).Conclusion Escherichia coli isolated from different samples have different resistant rates to the same antimicrobial agents,the treatment of infection in different sites should consider the difference in drug resistance and effective drug concentration,antimicrobial application should be rational and effective.