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周杰,张莉,徐康立,杨书才,张鲍虎,张扬.821株临床分离大肠埃希菌的耐药性分析[J].中国医药科学,2018,(3):51-54        基金项目:广东省深圳市坪山区卫生系统科研项目 (201519)
821株临床分离大肠埃希菌的耐药性分析
Analysis of drug resistance of 821 clinical isolates of Escherichia coli
  
DOI:
中文关键词:  大肠埃希菌;超广谱 β- 内酰胺酶;耐药性;合理用药
英文关键词:Escherichia coli; Broad-spectrum beta lactamase; Drug resistance; Rational use of drugs
作者单位
周杰,张莉,徐康立,杨书才,张鲍虎,张扬 深圳市坪山区人民医院检验科 
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中文摘要:
      目的 探讨我院大肠埃希菌对抗菌药物的耐药情况,为临床合理使用抗菌药物提供依据。 方法 收集我院 2015 年 1 月~ 2016 年 12 月间临床分离的 821 株大肠埃希菌,采用革兰氏阴性细菌药敏卡 AST-GN13进行药敏试验,并对药敏结果进行分类分析和总结。 结果 住院和门诊患者分离菌株耐药率最高的 3 种抗菌药物分别为氨苄西林(75.2%、64.1%)、氨苄西林 - 舒巴坦(50.0%、38.7%)、复方新诺明(46.2%、38.5%);住院分离株对氨苄西林、氨苄西林 - 舒巴坦、复方新诺明、头孢唑琳、头孢曲松、庆大霉素等抗菌药物的耐药性显著高于门诊患者分离株(P < 0.05);住院和门诊分离株产超广谱 β- 内酰胺酶(ESBLs)检出率分别为 41.1% 和 22.3%,差异有统计学意义(P < 0.05);除呋喃妥因和派拉西林 - 他唑巴坦外,产 ESBLs 株对常用抗菌药物的耐药性均高于不产酶菌株(P < 0.05);共检出 3 株耐碳青霉烯类药物菌株,均为住院分离株。 结论 我院大肠埃希菌对抗菌药物呈现不同程度的耐药,住院患者分离大肠埃希菌对抗菌药物的耐药性显著高于门诊患者,应重点加强住院患者细菌耐药的监控。
英文摘要:
      Objective To investigate the resistance of Escherichia coli to antibiotics in our hospital, and to provide the basis for the rational use of antibiotics in clinical practice. Methods 821 strains of Escherichia coli isolated from January 2015 to December 2016 in our hospital were collected. Drug sensitivity test was made by gram-negative bacterial drug sensitive card AST-GN13, the results of drug sensitivity were analyzed and summarized. Results The 3 kinds of antimicrobial agents with the highest drug resistance rate were Ampicillin (75.2%, 64.1%), ampicillin sulbactam (50%, 38.7%) and compound sulfamethoxazole (46.2%, 38.5%) respectively; The resistance of hospitalized isolates to ampicillin, ampicillin sulbactam, compound sulfamethoxazole, cefazolin, ceftriaxone, gentamicin and other antimicrobial agents was significantly higher than those of outpatients (P < 0.05); The detection rates of extended spectrum beta lactamase (ESBLs) in hospitalized and outpatient patients were 41.1% and 22.3%, respectively, and the difference was statistically significant (P < 0.05); In addition to nitrofurantoin and piperacillin tazobactam, antimicrobial resistance of ESBLs producing strains were higher than the commonly used enzyme producing strain (P < 0.05); 3 strains of carbapenem resistant strains were detected, all of which were isolated in hospital. Conclusion Escherichia coli in our hospital showed different degrees of resistance to antibiotics. The drug resistance of Escherichia coli isolated from hospitalized patients was significantly higher than that of outpatients, and the surveillance of bacterial resistance in hospitalized patients should be strengthened.
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