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李介华, 袁春雷, 肖伟民, 肖正儒, 邱文影. 大肠埃希菌产超广谱β-内酰胺酶与耐药监测[J]. 中国公共卫生, 2005, 21(5): 569-571.
引用本文: 李介华, 袁春雷, 肖伟民, 肖正儒, 邱文影. 大肠埃希菌产超广谱β-内酰胺酶与耐药监测[J]. 中国公共卫生, 2005, 21(5): 569-571.
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LI Jiehua, YUAN Chunlei, XIAO Weimin, . Surveillance on antibiotic resistance and extend-spectrum beta-lactamase of clinical Escherichia coil[J]. Chinese Journal of Public Health, 2005, 21(5): 569-571.
Citation: LI Jiehua, YUAN Chunlei, XIAO Weimin, . Surveillance on antibiotic resistance and extend-spectrum beta-lactamase of clinical Escherichia coil[J]. Chinese Journal of Public Health, 2005, 21(5): 569-571.
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大肠埃希菌产超广谱β-内酰胺酶与耐药监测

Surveillance on antibiotic resistance and extend-spectrum beta-lactamase of clinical Escherichia coil

    摘要
  • 摘要:
      目的   观察大肠埃希菌临床分离株的耐药变迁和门诊(社区)、住院病人的不同耐药特点及产超广谱β-内酰胺酶(ESBLs)的流行情况。
      方法   应用Micro Scan Auto Scan-4专用NC鉴定板检测24 4株大肠埃希菌对20种抗生素的敏感程度, 根据仪器专家系统筛选产可疑ESBLs菌株, 用表型确认试验进行确认。
      结果   3年来哌拉西林/他唑巴坦、亚胺培南对大肠埃希菌敏感性稳定在90%以上, 阿米卡星、头孢他啶、头孢西丁的敏感性稳定在70%以上; 2001年与2003年相比, 头孢噻肟的耐药性明显增加, 差异有统计学意义(χ2=7.86, P < 0.05);来源于门诊、一般住院病人和重症监护病房(ICU)的菌株对头孢唑啉、头孢他啶、头孢噻肟、头孢曲松和环丙沙星的耐药性逐渐增高(P < 0.05或0.01), 产ESBLs大肠埃希菌对第4代头孢菌素中头孢吡肟的耐药率高达72.2%, 明显高于头孢他啶耐药率(40.7%, χ2=21.77, P < 0.01), 产ESBLs大肠埃希菌对其他第3代头孢菌素耐药 > 70%;门诊、一般住院病人和ICU的产ESBLs大肠埃希菌分离率分别为30.8%, 46.5%, 85.7%(χ2=9.08, P < 0.05)。
      结论   门诊、一般住院病人和ICU分离的大肠埃希菌耐药率递次增高与产ESBLs大肠埃菌分离率增加有关; 产ESBLs大肠埃希菌已对头孢吡肟呈高耐药性; 社区感染产ESBLs大肠埃希菌的高检出率不容忽视。

     

    Abstract:
      Objective   To observe the antibiotic resistance trend of clinical isolated Escherichia coil; the different drug resistance in the community acquired infection and hospital patient; the prevalence of partly strains producing Extended Spectram B-lactamases(ESBLs)in Qingyuan district.
      Methods   The sensitivity of 244 Escherichia coil to 20 antibiotics were tested by MicroScan AutoScan-4 and ESBLs were identified by disc agar diffusion method.
      Results   Forthree years the sensitivity rate of imipenem and piperacilin/tazobactam firmly kept on higher than 90%, and that of amikacin, cefoxitin, ceftazidime was higher than 70%.The resistance rate of cefotaxime in 2003 was significantly higher than that in 2001(χ2=7.86, P < 0.05).The resistance rates of ceftazidime, cefazoline, cefotaxime, ceftriax one and ciprofloxacin were gradually raised in the strains isolated from community acquired infection, hospital patient and ICU(P < 0.05 or 0.01), The rate of strains producing ESBLs was 30.8%, 46.5%, 85.7% respectively.(χ2=9.08, P < 0.05).The resistance rate of cefepime (72.2%)was significantly higher than that of ceftazidime(40.7%)in strains producing ESBLs(χ2=, P < 0.01), the resistance rate of other third-Cef was higher than 70%.
      Conclusion   There was a significant relation between the high drug resistance rate and the rate of strains producing ESBLs, which was gradually raised in the strains isolated from community acquired infection, hospital patient, and ICU.The high rate of strains producing ESBLs in community acquired infection should be considered severely.

     

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