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目的分析大肠埃希菌在临床感染的分布特点及耐药性,为临床合理选择抗菌药物提供理论参考。方法2013-05/2015-05山东省巨野县大义医院对210株临床标本分离的大肠埃希菌的分布进行回顾性分析,细菌药敏试验采用K-B纸片扩散法,PCR法检测耐药基因分布情况。结果各种临床标本中共分离出病原菌1 595株,其中大肠埃希菌210株,占13.17%;大肠埃希菌主要分离自中段尿、痰液、分泌物、血液及咽拭子,分别占分离株构成比的30.48%、21.43%、19.05%、13.33%和5.71%;产ESBLs大肠埃希菌总检出率为60.95%(128/210),其中以痰标本检出率最高,为82.22%。大肠埃希菌对亚胺培南和美罗培南敏感率均为100.0%;对厄他培南、阿米卡星、头孢西丁、头孢哌酮均敏感,总耐药率分别为1.9%、9.5%、9.5%和14.3%;对青霉素类、三代头孢菌素类及喹诺酮类药物耐药率高,产ESBLs大肠埃希菌的耐药性显著高于非产耐药性的大肠埃希菌。结论山东省巨野县大义医院临床分离大肠埃希菌耐药率较高,临床应根据药敏试验结合患者病情选择抗菌药物。
Objective To analyze the distribution characteristics and drug resistance of Escherichia coli in clinical infection and provide theoretical reference for the rational selection of antibacterials in clinic. Methods From May 2013 to May 2015, the distribution of 210 clinical isolates of Escherichia coli was analyzed retrospectively in Dayi Hospital of Juye County, Shandong Province. Bacterial susceptibility test was performed by KB disk diffusion method and PCR method was used to detect the resistance gene Distribution. Results A total of 1 595 strains of pathogens were isolated from clinical samples, of which 210 strains were Escherichia coli (accounting for 13.17%). Escherichia coli mainly isolated from the urine, sputum, secretions, blood and throat swabs The total detection rate of ESBLs-producing Escherichia coli was 60.95% (128/210), among which the highest detection rate was sputum specimens (82.22%), . The sensitivity rates of Escherichia coli to imipenem and meropenem were 100.0%, and all of them were sensitive to ertapenem, amikacin, cefoxitin and cefoperazone, with the overall rates of resistance being 1.9%, 9.5% , 9.5% and 14.3%, respectively. The resistance rates to penicillins, third generation cephalosporins and quinolones were high, and the drug resistance of ESBLs-producing Escherichia coli was significantly higher than that of non-drug-resistant Escherichia coli. Conclusion The clinical isolates of Escherichia coli isolated from Dayi Hospital of Juye County, Shandong Province have a high resistance rate. Antibiotics should be selected according to the drug sensitivity test combined with the patient’s condition.