大肠埃希菌近三年耐药监测结果分析

目的:了解大肠埃希菌对常用抗生素的耐药性及耐药趋势,以指导临床合理用药.方法应用WHONET5对我院2004年1月～2006年7月临床分离的616株大肠埃希菌药敏结果进行统计分析.结果大肠埃希菌对氨苄西林、哌拉西林、奥格门叮、复方磺胺、环丙沙星耐药率大于60%,庆大霉素、头孢唑林、头孢呋新耐药率在50%左右,哌拉西林/他唑巴坦、头孢吡肟、头孢他啶、头孢西丁、阿米卡星和呋喃妥因耐药率较低,均小于20%,亚胺培南无耐药菌株;大肠埃希菌ESBLs检出率2004～2006年分别为27.96%、32.68%、35.12%.结论:大肠埃希菌对青霉素类及青霉素类/克拉维酸、磺胺类、喹诺酮类、庆大霉素、第一代头孢、第二代头孢已高度耐药,临床不宜选用;青霉素类/他唑巴坦、第四代头孢、头霉素类、碳青霉烯类、阿米卡星、呋喃类耐药率较低,临床可选用;第三代头孢耐药率也较低,由于易诱导ESBLs应慎用;大肠埃希菌产ESBLs率呈逐年上升的趋势.

Analysis of the monitorin resistance data of E.coli in recent three years

Objective:To study the resistance and its tendency of E.coli to antibiotics was to serve the rational administration in clinic.Methods:WHONET5 was employed to analyze the drug sensitivities of 616 E.coli isolated from the clinical specimens from January,2004 to July,2006 in hospital.Results:The resistance rates of E.coli to Ampicillin,Piperacillin,Amoxicillin/cla,Trimethoprim/Sulfamethoxazole and Ciprofloxacin exceeded 60%,and they were about 50% to Gentamicin,Cefazolin and Cefuroxime.In addition,the resistant rates were20% infra to Piperacillin/tazobactam,Cefepime,Ceftazidime,Cefoxitin,Amikacin and Furantoin,and there was no resistance to Imipenem.The detection rates of ESBLs to E.coli was 27.96%,32.68%,35.12% in 2004,2005,2006 respectively.Conclusions:The resistance rates of E.coli to Penicillins,Piperacillins/Clavulanic acid,Sulfanilamide,Quinolone,Gentamicin,the first and second generations Cephalosporins were high,and they were not suitable for clinical use.To Piperacillins/tazobactam,fourth generation Cephalosporins,Cephamycins,Imipenem,Amikacin and Furantoin,the resistance rates were relatively low,and they could be used clinically.The third generation Cephalosporins should be used cautiously due to its feasibility of inducing ESBLs even though its resistant rates were low.The production rate of ESBLs of E.coli ascended year by year.