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目的分析住院新生儿临床标本中分离的大肠埃希菌对抗菌药物的耐药性状况,寻找新生儿病房大肠埃希菌耐药基因来源,为临床合理用药提供依据。方法收集2009年9月至2011年11月本院住院新生儿的临床标本,将从中分离的大肠埃希菌作为研究对象,采用纸片扩散法(K-B法)检测大肠埃希菌对8种抗生素的耐药性。结果共分离出100株大肠埃希菌,这些菌株对8种抗菌药物的耐药率从高到低依次为头孢噻肟(67%)、四环素(58%)、左氧氟沙星(34%)、头孢吡肟(33%)、头孢西丁(26%)、氯霉素(19%)、阿米卡星(13%),未发现对美罗培南耐药的菌株。100株大肠埃希菌超广谱β-内酰胺酶(ESBLs)检出率为55%,痰液大肠埃希菌菌株ESBL检出率为65%,明显高于无菌体液(血液、脑脊液)的27%。产ESBL大肠埃希菌菌株对头孢噻肟、头孢吡肟的耐药率明显高于非产ESBL大肠埃希菌菌株。大肠埃希菌多重耐药率为15%,耐药谱型以β-内酰胺类、氨基糖苷类、喹诺酮类、氯霉素类、四环素为主,占8%。结论住院新生儿临床送检标本中,大肠埃希菌对头孢类抗生素耐药情况严重,对大肠埃希菌的耐药率及耐药模式进行连续监测,对于临床用药有重要价值。
Objective To analyze the resistance status of Escherichia coli isolated from clinical samples of in-hospital neonates to antibacterials and find out the source of Escherichia coli resistance genes in neonatal ward, so as to provide basis for clinical rational drug use. Methods The clinical samples of neonates hospitalized in our hospital from September 2009 to November 2011 were collected. Escherichia coli isolated from them was used as the research object, and KB method was used to detect the effect of Escherichia coli on eight kinds of antibiotics Drug resistance. Results A total of 100 strains of Escherichia coli were isolated. The antibiotic resistance rates of these strains to cefotaxime (67%), tetracycline (58%), levofloxacin (34%) and ceftazidime (33%), cefoxitin (26%), chloramphenicol (19%) and amikacin (13%). No strains resistant to meropenem were found. 100 strains of Escherichia coli ESBLs detection rate was 55%, sputum Escherichia coli ESBL detection rate was 65%, significantly higher than the sterile body fluid (blood, cerebrospinal fluid) Of the 27%. The ESBL-producing Escherichia coli strains resistant to cefotaxime and cefepime were significantly higher than ESBL-non-Escherichia coli strains. The rate of multidrug-resistant Escherichia coli was 15%. The resistant spectrum was mainly β-lactam, aminoglycoside, quinolone, chloramphenicol and tetracycline, accounting for 8%. Conclusion In hospitalized neonatal clinical specimens, Escherichia coli has a serious resistance to cephalosporins, and the drug resistance rate and drug resistance of Escherichia coli are continuously monitored, which is of great value to clinical medication.