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目的了解社区与医院内感染大肠埃希菌的分布及耐药特点。方法按社区感染与医院内感染进行分类,对临床检出的1 235株大肠埃希菌的分布和耐药情况进行比较分析。结果 1 235株大肠埃希菌中,社区感染占84.5%,医院内感染占15.5%。临床分离的大肠埃希菌标本主要来源于尿液、脓液、分泌物、痰液和血液;社区感染大肠埃希菌标本主要来自胃肠外科、泌尿外科和儿科,医院内感染菌株则主要来源于综合ICU、胃肠外科和神经内科。医院内感染大肠埃希菌患者60岁以上的占47.9%,平均住院费用、平均药品费用、平均抗菌药物费用高于社区感染患者。医院内感染大肠埃希菌对常用抗菌药物的耐药率普遍高于社区感染大肠埃希菌。结论该院大肠埃希菌感染主要来源于社区感染,但医院内感染菌株在耐药率、患者平均住院日及住院费方面显著高于社区感染,综合ICU及相关外科科室是防控重点,在抗菌药物的选择上应有所区别。
Objective To understand the distribution and drug resistance of Escherichia coli in community and hospital. Methods According to the classification of community infection and nosocomial infection, the distribution and drug resistance of 1 235 strains of Escherichia coli clinically detected were compared. Results Among the 1 235 Escherichia coli strains, 84.5% were community-based and 15.5% were nosocomial infections. Escherichia coli clinically isolated mainly from urine, pus, secretions, sputum and blood samples; community-acquired Escherichia coli specimens mainly from gastrointestinal surgery, urology and pediatrics, the main source of hospital infection strains In Integrated ICU, Gastrointestinal Surgery and Neurology. Patients with Escherichia coli in hospital over the age of 60 accounted for 47.9% of the average cost of hospitalization, the average cost of drugs, the average cost of antimicrobial drugs than community-infected patients. Escherichia coli infection in hospitals generally resistant to commonly used antimicrobial drugs than community-acquired Escherichia coli. Conclusion The infection of Escherichia coli in this hospital mainly originated from community infection. However, the infection rate of hospital inpatients was significantly higher than that of community infection in the rate of drug resistance, average length of stay and cost of hospitalization. Comprehensive ICU and related surgical departments were the focus of prevention and control. The choice of antibacterial drugs should be different.