大肠埃希菌临床分离株的耐药性分析

摘要

Objective To analyze the change trend of drug resistance in clinical strains of Escherichia coli,and to provide the basis for rational use of antibiotics in clinic,and to increase the level of drug resistance.Methods The drug resistance of Escherichia coli isolated from various clinical specimens in hospital from January 2012 to November 2016 were analyzed retrospectively.Results From all kinds of clinical specimens 3 458 strains of Escherichia coli were isolated,extended spectrum beta-lactamases producing rate of which was 57.92％.The drug resistance rates of Escherichia coli to Quinolones,Penicillins,Cephalosporins,Aminoglycosides,Sulfonamides were more than 50.00％;The resistance rate of Imipenem,Meropenem,Piperacillin/Tazobactam,Cefoperazone/Sulbactam and Cefoxitin were less than 10.00％ of the antibacterial drugs,the resistance to some third,forth generation Cephalosporins were significantly increased.The Wilcoxon test showed that drug resistance rate of Escherichia coli isolated from sputum was significantly higher than that of blood,urine,secretions,the difference was statistically significant(P<0.05).Conclusion Clinicians should attach great importance to which the drug resistance of Escherichia coli in a hospital increased year by year.%目的 分析大肠埃希菌临床分离株的耐药水平的变化趋势,为临床合理使用抗菌药物,延缓该菌耐药水平的升高提供依据.方法 回顾性分析该院2012年1月至2016年11月各类临床标本大肠埃希菌分离株的耐药情况.结果 从各类临床标本中分离出大肠埃希菌3 458株,其中产超广谱β-内酰胺酶菌的检出率为57.92％,大肠埃希菌对氟喹诺酮类、青霉素类、头孢菌素类、磺胺类和氨基糖苷类等的耐药率均超过50.00％;对亚胺培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦和头孢西丁的耐药率低于10.00％,对部分第3、4代头孢菌素的耐药性呈增加趋势.经Wilcoxon检验发现痰液中分离出的大肠埃希菌的耐药率显著高于血液、尿液、分泌物,差异有统计学意义(P<0.05).结论 该院大肠埃希菌的耐药水平逐年升高,对此,临床医师应予以足够地重视.