尿道感染大肠埃希菌对喹诺酮耐药性及相关因素分析

摘要

Objective To investigate the drug resistance and risk factors of Escherichia coli isolated from urinary tract infection (UTI) to quinolone. Methods Drug resistance of 705 strains of Escherichia coli isolated from 749 urine specimens of UTI from 2010 to 2011 in our hospital were detected and divided into the resistance group and the sensitive group according to sensitiveness to quinolone, and the risk factors of the quinolone resistance strains were analyzed. Results In 705 strains isolates E. coli, there were 474 strains (67. 2% ) of quinolone resistance in the resistance group, 231 strains (32. 8% ) of quinolone sensitiveness in the sensitive group and there was no carbapenem resistant strain. The differences in resistance rates of amoxicillin/clavulanic acid, cefotaxime, ceftazidime, aztreonam, piperacillin, amikacin, bactrim, gentamicin and cefepime of the two groups were statistically significant (P<0. 05) . Logistic regression analysis showed that the proportion of female patients, drug use of tert-cephalosporins and quinolones, urinary drainage and bacterium producing extended spectrum β lactamases (ESBLS) were independent risk factors of quinolone resistance E. coli. The differences in hospital stay and cost of the two groups were statistically significant (P<0. 05). Conclusion The detection rate of quinolone resistance escherichia coli isolated from UIT is high. The emergence of resistant strains is related to antibiotic application, invasive handling and bacterial variation. To strengthen the independent risk factors regulation can effectively prevent and control spread of infection.%目的 探讨尿道感染(urinary tract infection,UIT)大肠埃希菌对喹诺酮耐药性及其相关因素.方法 对我院2010-2011年749例UIT尿液标本中分离的705株大肠埃希菌的耐药性进行检测,以对喹诺酮敏感与否分为耐药株组和敏感株组,分析耐药株感染的相关因素.结果 705株大肠埃希菌中对喹诺酮耐药474株(67.2％)(耐药株组),敏感231株(32.8％)(敏感株组),未见碳青霉烯耐药株.耐药株组对阿莫西林/克拉维酸、头孢噻肟、头孢他啶、氨曲南、哌拉西林、阿米卡星、复方新诺明、庆大霉素、头孢吡肟的耐药率与敏感组比较差异有统计学意义(P＜0.05).Logistic回归分析显示女性患者、三代头孢及喹诺酮类药物使用、尿路引流和细菌产生超广谱β-内酰胺酶(ESBLS)是喹诺酮耐药株出现的独立危险因素.两组在住院时间和住院费用方面比较差异亦有统计学意义(P＜0.05).结论 UIT大肠埃希菌中喹诺酮耐药株的检出率高,耐药株的出现与抗生素应用及侵入性操作、细菌变异等有关,加强对危险因素的控制有助于预防和控制感染.