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目的分析医院感染大肠埃希菌的分离情况及耐药性,为指导临床使用抗菌药物提供参考。方法回顾性调查分析2014年1月至2015年12月临床分离的1 939株大肠埃希菌,菌株经VITEK-2compact全自动微生物分析仪进行鉴定和药敏试验,用WHONET 5.6软件进行数据分析。结果 1 939株大肠埃希菌主要来源于尿液,占52.6%,其次为血液、痰液,分别占11.2%、10.1%;标本病区来源主要为泌尿外科、妇科和ICU,分别占24.9%、8.8%、6.2%;检出产超广谱β内酰胺酶(ESBLs)大肠埃希菌1 158株,占59.7%;大肠埃希菌对氨苄西林的耐药率最高,达87.3%,对氨苄西林/舒巴坦、头孢唑啉、头孢曲松、复方新诺明、左旋氧氟沙星、环丙沙星的耐药率>50.0%,而对亚胺培南、头孢替坦、呋喃妥因、阿米卡星、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的耐药率<30%,对厄他培南100.0%敏感。结论大肠埃希菌对临床抗菌药物的耐药率很高,临床应根据药敏结果合理选用抗菌药物。
Objective To analyze the isolation and drug resistance of Escherichia coli in hospital and provide references for clinical use of antibacterials. Methods A total of 1 939 strains of Escherichia coli isolated from January 2014 to December 2015 were retrospectively investigated. The strains were identified by VITEK-2compact automatic microbiological analyzer and susceptibility testing was conducted. Data were analyzed by WHONET 5.6 software. Results 1 939 strains of Escherichia coli mainly originated from urine, accounting for 52.6%, followed by blood and sputum, accounting for 11.2% and 10.1% respectively. The main source of specimens was urology, gynecology and ICU, accounting for 24.9% , 8.8% and 6.2% respectively. A total of 1 158 ESBLs-producing Escherichia coli strains were detected, accounting for 59.7% of the total. Escherichia coli was the most resistant to ampicillin (87.3%), Ampicillin / sulbactam, cefazolin, ceftriaxone, cotrimoxazole, levofloxacin, ciprofloxacin resistance rate of> 50.0%, and imipenem, cefotetan, nitrofurantoin , Amikacin, cefoperazone / sulbactam, piperacillin / tazobactam resistance rate of <30%, sensitive to ertapenem 100.0%. Conclusion Escherichia coli has a high rate of resistance to clinical antimicrobial agents. Antimicrobial agents should be selected according to the susceptibility results.