2009年至2010年23种抗菌药物对大肠埃希菌敏感趋势分析

目的 通过对医院分离的大肠埃希菌药物敏感性报告分析,为临床提供合理选择抗菌药物的依据,避免盲目使用或滥用抗菌药物,延缓或减少耐药菌株的产生,提高感染治愈率.方法 采用2009年至2010年医院检验科提供的感染患者送检标本经分离、菌种鉴定和药物敏感性分析后的实验数据报告,对其报告进行统计分析.结果 2009年至2010年,医院分离出大肠埃希菌559株,居所有分离菌株数量之首;除了碳青霉烯类、头孢菌素类、阿米卡星和部分β-内酰胺酶抑制剂组成的复方制剂以外,其他抗菌药物对大肠埃希菌的敏感率很低甚至完全耐药,并且高于2006 - 2007年度卫生部全国细菌耐药监测网(Mohnarin)革兰阴性杆菌耐药情况报告发布的数据.结论 随着抗生素大量及长时间的使用,尤其是第3代、第4代头孢菌素的广泛应用或侵袭性操作等因素,导致大肠埃希菌产超广谱β-内酰胺酶(ESBLs)甚至产金属β-内酰胺酶(NDM -1)增加,耐药现象严重,给临床治疗带来困难.

Analysis on Sensitivity Trend of Escherichia Coli to 23 Antibacterial Agents during 2009-2010

Objective To analyze the drug sensitivity reports on Escherichia coli isolated from our hospital to provide evidence of rational antibacterial use for avoiding blind or abuse drug use,delaying or reducing the production of drug-resistant strains and increasing the cure rate of anti-infection.Methods To adopt the data of the experimental analysis reports of isolation,strain identification and drug sensitivity on the specimens collected from the infected patients during 2009-2010 for conducting the statistical analysis.Results 559 strains of Escherichia coli were separated from 2009 to 2010,ranking first in all isolated strains.Excepting for carbapenems,cephamycin,amikacin and partial compound preparations consisted of beta-lactamase inhibitors,other antimicrobial drugs had lower sensitivity rate or even complete resistance to Escherichia coli,and which was higher than the resistance rate in the 2006-2007 annual report of Gram-negative bacilli drug resistance announced by the Moh National Antimicrobial Resistant Investigation Net（Mohnarin）.Conclusion Along with extensive and long-term use of antibiotics,the causes such as especially extensive use of beta-lactams cephalosporin drugs such as the third and fourth generation cephalosporin or invasive operation lead to the increase of extended spectrum beta-lactamase（ESBLs）producing or even New Delhi metallo-beta-lactamase（NDM-1）producing Escherichia coli and the serious phenomenon of drug resistance,which brings difficulty to clinical treatment.