目的：了解无氟喹诺酮类抗菌药物用药史的健康儿童肠道大肠埃希菌产超广谱β‐内酰胺酶（ESBLs）菌株的检出率及对常用药物的耐药状况，为临床儿科大肠埃希菌产 ESBLs菌株异位感染的经验用药提供依据。方法从440例健康儿童大便中分离、鉴定大肠埃希菌，采用法国梅里埃VITEK‐2 compact的AST‐13全自动微生物鉴定药敏检测系统仪与K‐B纸片扩散法进行药敏试验及ESBLs表型确认试验。用WHONET5．3软件分析药敏试验数据，采用SPSS19．0进行耐药率数据分析。结果440株大肠埃希菌产ESBLs率为47．3％，产酶株与非产酶株的耐药率分别是：头孢他啶80．8％、43．1％；头孢噻肟80．8％、43．9％；头孢曲松88．5％、51．7％；头孢吡肟73．1％、34．5％；环丙沙星57．7％、39．7％；左氧氟沙星51．9％、37．9％；阿米卡星11．5％、3．4％。结论南充地区部分无氟喹诺酮类抗菌药物用药史的健康儿童肠道内大肠埃希菌具有产ESBLs的较高概率，且对3、4代头孢类、氟喹诺酮类、氨基糖苷类抗菌药物具有不同程度的多重耐药性。%Objective To understand the fluorine free history of quinolones drugs in the intestines of healthy children E. coli to produce ultra broad spectrum beta lactamase (ESBLs)strains of detection rate and drug resistance to commonly used medicines, for clinical pediatric E. coli producing ESBLs strains of ectopic infection provides the ba‐sis for empirical use. Methods E. coli in the stool were separated and identificated from 440 healthy children, VITEK‐2 compact AST‐13 and K‐B disc diffusion method were used for drug susceptibility and ESBLS phenotype confirmation test. WHONET5. 3 software was used to analyze susceptibility data, and SPSS19. 0 was used to analyze the percentages of data. Results The producing ESBLs rate was 47. 3% for 440 strains of E. coli, The drug resist‐ance rate of enzyme production strains and non‐enzyme production strains respectively :Ceftazidime were 80. 8%, 43. 1% ;Cefotaxime were 80. 8%, 43. 9% ;Ceftriaxone were 88. 5%, 51. 7% ;Cefepime were 73. 1%, 34. 5% ;Cipro‐floxacin were 57. 7%, 39. 7% ;Levofloxacin were 51. 9%, 37. 9% ;Aminoglycoside amikacin were 11. 5%, 3. 4%. Con‐clusion The region part of fluorine‐free quinolones drugs with a history of healthy children in the gut of E. coli has a higher probability of producing ESBLs, and for 3, 4 generation cephalosporins, fluoroquinolone, aminoglycoside antibi‐otic drugs with different degree of multiple drug resistance.
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