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目的了解临床分离的大肠埃希菌的标本分布及常用18种抗菌药物的耐药性,为减少耐药性的发生提供依据,指导临床合理用药。方法收集2014年1月至2015年12月我院临床送检标本,对检出的1840株大肠埃希菌标本分布及细菌耐药性进行回顾性分析。结果临床分离到1840株大肠埃希菌,主要分离自清洁中段尿液63%(1 148/1822),伤口分泌物16.5%(300/1822),痰液11.7%(213/1822),血液4.5%(81/1822)。对氨苄西林耐药率达83.2%,对哌拉西林的耐药率78.4%,对头孢唑啉的耐药率68.5%,对环丙沙星、头孢呋辛钠、复方新诺明、头孢曲松和左氧氟沙星耐药率均大于50%,对哌拉西林/他唑巴坦、阿米卡星、妥布霉素和头孢他啶的耐药率低于3%。结论大肠埃希菌是医院感染的首要病原菌,临床治疗大肠埃希菌引起的感染时应根据药敏结果合理选择抗菌药物。
OBJECTIVE To understand the distribution of specimens of clinical isolates of Escherichia coli and the drug resistance of 18 kinds of commonly used antibiotics to provide the basis for reducing the occurrence of drug resistance and to guide clinical rational drug use. Methods The clinical specimens from January 2014 to December 2015 in our hospital were collected and the distribution and bacterial resistance of 1840 strains of Escherichia coli were retrospectively analyzed. Results 1840 strains of Escherichia coli were isolated clinically, which were mainly isolated from 63% (1 148/1822) urine of the clean center, 16.5% (300/1822) of wound secretions, 11.7% (213/1822) of sputum and 4.5 % (81/1822). The rate of resistance to ampicillin was 83.2%, resistance to piperacillin 78.4%, resistance to cefazolin 68.5%, to ciprofloxacin, cefuroxime sodium, cotrimoxazole, cefotaxime Resistant rates of levofloxacin to pine and levofloxacin were both above 50%. The resistance rate to piperacillin / tazobactam, amikacin, tobramycin and ceftazidime was less than 3%. Conclusion Escherichia coli is the most important pathogen of nosocomial infection. In the clinical treatment of Escherichia coli-induced infections, antibacterial drugs should be selected reasonably based on the susceptibility results.