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目的通过分析大肠埃希菌的临床感染分布及耐药情况,为临床大肠埃希菌感染治疗与控制提供依据。方法选取某院2014年1月-2016年12月临床分离的763株大肠埃希菌为研究对象,分别采用全自动微生物鉴定仪进行检测与药敏试验。结果大肠埃希菌主要标本类型为尿液,占55.6%,血液和分泌物标本分别占14.7%和9.2%,763株大肠埃希菌在泌尿科分布最多,占29.5%,普外科和内分泌科分别占15.5%和14.0%。大肠埃希菌对临床常用抗菌药物亚胺培南、美罗培南、阿米卡星敏感率较高,分别为96.7%、97.2%、91.6%,头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢西丁次之,分别为76.4%、76.7%、75.8%,头孢菌素类和氟喹诺酮类敏感率较低,(头孢呋辛30.1%,头孢他啶42.8%、头孢曲松31.6%、头孢吡肟39.9%、左氧氟沙星37.7%、诺氟沙星28.7%),耐碳青霉烯类大肠埃希菌在2014-2016年度耐药率有上升趋势(亚胺培南χ~2=9.796,P=0.007;美罗培南χ~2=8.243,P=0.016)。结论临床大肠埃希菌耐药分布广及耐药率高,应加强对该菌的耐药性监测及合理选用抗菌药物。
Objective To analyze the distribution and drug resistance of Escherichia coli in clinical infection and provide evidence for the treatment and control of clinical Escherichia coli infection. Methods A total of 763 Escherichia coli isolated from a hospital from January 2014 to December 2016 were selected as test objects and tested by automatic microbiological analyzer. Results The main types of Escherichia coli were urine, accounting for 55.6%, blood and secretions accounting for 14.7% and 9.2%, 763 Escherichia coli most widely distributed in urology, accounting for 29.5%, general surgery and endocrinology Accounting for 15.5% and 14.0% respectively. Escherichia coli has a high sensitivity to commonly used antibiotics such as imipenem, meropenem and amikacin, which are 96.7%, 97.2%, 91.6%, cefoperazone / sulbactam, piperacillin / Zoxaban and cefoxitin followed by 76.4%, 76.7% and 75.8% respectively, with low sensitivity rates for cephalosporins and fluoroquinolones (cefuroxime 30.1%, ceftazidime 42.8% and ceftriaxone 31.6% , 39.9% of cefepime, 37.7% of levofloxacin, and 28.7% of norfloxacin). The resistance rate of carbapenem-resistant Escherichia coli in 2014-2016 is on the rise (imipenem χ ~ 2 = 9.796 , P = 0.007; Meropenem χ ~ 2 = 8.243, P = 0.016). Conclusion The clinical isolates of Escherichia coli are widely distributed and resistant to drugs. Therefore, the drug resistance of the bacteria should be monitored and antibacterials should be selected reasonably.