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目的了解大肠埃希菌在不同标本中的分布及耐药情况,为指导临床治疗大肠埃希菌感染疾病提供实验室依据。方法收集安徽理工大学第一附属医院2014年1月—2016年8月中分离自痰、脓汁、全血、中段尿等标本,采用BD公司的PhoenixTM100全自动微生物分析系统进行大肠埃希菌鉴定及药敏检测,统计并比较各种标本中分离检出的大肠埃希菌的耐药率。结果共分离647株大肠埃希菌,其中分离率最高的是脓汁(26.74%),其次为中段尿(21.48%)、全血(14.53%)、痰(14.37%)、分泌物(13.45%)、其他(9.43%)。647株大肠埃希菌中ESBLs阳性菌株为411株,阳性率为63.52%。ESBLs阳性大肠埃希菌对亚胺培南和美洛培南的耐药率分别为0.73%和0.97%。其他抗菌药物的耐药率分别为:氨苄青霉素99.76%、哌拉西林99.27%、头孢噻肟99.27%;ESBLs阴性大肠埃希菌耐药率由高到低依次为氨苄青霉素75.64%,哌拉西林71.91%,四环素59.15%,ESBLs阳性大肠埃希菌的耐药率显著高于ESBLs阴性大肠埃希菌(P<0.01)。结论大肠埃希菌是临床常见的致病菌,ESBLs阳性大肠埃希菌耐药情况较ESBLs阴性菌株更加严峻,应熟悉大肠埃希菌产ESBLs的情况和变化趋势,加强对其监督和管理,避免因盲目用药诱导耐药菌株的出现及扩散。
Objective To understand the distribution and drug resistance of Escherichia coli in different specimens and to provide laboratory evidence for clinical treatment of Escherichia coli infection. Methods The specimens collected from sputum, pus, whole blood and middle urine in the First Affiliated Hospital of Anhui University of Science and Technology from January 2014 to August 2016 were collected and used for the identification of Escherichia coli using the PhoenixTM100 automatic microbiological analysis system of BD Company And drug susceptibility testing, statistics and comparison of various specimens isolated from the detection of Escherichia coli resistance. Results A total of 647 Escherichia coli isolates were isolated, of which pus was the highest (26.74%), followed by middle urine (14.53%), whole blood (14.37%), secretions ), Others (9.43%). The number of ESBLs positive strains in 647 Escherichia coli strains was 411, with a positive rate of 63.52%. The resistance rates of ESBLs-positive Escherichia coli to imipenem and meropenem were 0.73% and 0.97%, respectively. The resistance rates of other antibiotics were as follows: 99.76% of ampicillin, 99.27% of piperacillin and 99.27% of cefotaxime. The resistance rates of ESBLs-negative Escherichia coli from high to low were as follows: ampicillin 75.64%, piperacillin 71.91% and tetracycline 59.15%. The drug resistance rate of ESBLs positive Escherichia coli was significantly higher than that of ESBLs negative Escherichia coli (P <0.01). Conclusions Escherichia coli is a common clinical pathogen. The drug-resistant status of ESBLs-positive Escherichia coli is more serious than that of ESBLs-negative strains. It should be familiar with the situation and trend of ESBLs-producing Escherichia coli, strengthen the supervision and management of ESBLs- Avoid blind drug-induced emergence of resistant strains and proliferation.