郭远瑜, 董华丽, 窦琳琳, 徐洁颖. 2007-2011年浙江萧山地区尿路感染患者大肠埃希菌的分离及产超广谱-内酰胺酶和耐药性分析[J]. 疾病监测, 2012, 27(11): 873-876. DOI: 10.3784/j.issn.1003-9961.2012.11.010
引用本文: 郭远瑜, 董华丽, 窦琳琳, 徐洁颖. 2007-2011年浙江萧山地区尿路感染患者大肠埃希菌的分离及产超广谱-内酰胺酶和耐药性分析[J]. 疾病监测, 2012, 27(11): 873-876. DOI: 10.3784/j.issn.1003-9961.2012.11.010
GUO Yuan-yu, DONG Hua-li, DOU Lin-lin, XU Jie-ying. Isolation of Escherichia coli and analysis on its extended spectrum -lactamases production and drug resistance in patients with urinary tract infection in Xiaoshan, Zhejiang, 2007-2011[J]. Disease Surveillance, 2012, 27(11): 873-876. DOI: 10.3784/j.issn.1003-9961.2012.11.010
Citation: GUO Yuan-yu, DONG Hua-li, DOU Lin-lin, XU Jie-ying. Isolation of Escherichia coli and analysis on its extended spectrum -lactamases production and drug resistance in patients with urinary tract infection in Xiaoshan, Zhejiang, 2007-2011[J]. Disease Surveillance, 2012, 27(11): 873-876. DOI: 10.3784/j.issn.1003-9961.2012.11.010

2007-2011年浙江萧山地区尿路感染患者大肠埃希菌的分离及产超广谱-内酰胺酶和耐药性分析

Isolation of Escherichia coli and analysis on its extended spectrum -lactamases production and drug resistance in patients with urinary tract infection in Xiaoshan, Zhejiang, 2007-2011

  • 摘要: 目的 调查和分析浙江萧山医院尿路感染患者中大肠埃希菌的临床分布、产超广谱-内酰胺酶(extended spectrum -lactamase,ESBLs)和耐药特性,为临床合理利用抗菌药物提供依据。 方法 调查2007-2011年尿培养检出的大肠埃希菌, 对其临床分布进行分析;使用VITEK-60全自动微生物分析仪作细菌鉴定;采用K-B琼脂扩散法检测耐药情况。 结果 共分离出771株大肠埃希菌,其中52.5%(405/771)产ESBLs,主要来源于泌尿外科、内科和肾病科等科室,超过总分离菌株的60.0%,产ESBLs大肠埃希菌检出率从2007年的44.2%增高到2011年的61.2%(P0.01),且2007-2011年大肠埃希菌对多种抗菌药物的耐药率都有增高趋势,尤以对三、四代头孢菌素的增幅更为明显。ESBLs阳性株对氨苄西林、头孢唑啉、头孢他啶等16种药物的耐药率均高于ESBLs阴性株,差异有统计学意义(P0.01)。 结论 尿路感染大肠埃希菌对头孢类药物耐药率逐年升高,产ESBLs菌株检出率也呈逐年增高趋势,且表现为多重耐药,临床应合理使用抗生素。

     

    Abstract: Objective To investigate clinical distribution of Escherichia coli isolated from urinary tract infection(UTI) patients and its drug resistance in our hospital from 2007 to 2011 and provide evidence for the rational clinical drug use and reduction of extended spectrum lactamases(ESBLs) production. Methods Retrospective survey was carried out on the clinical distribution of the E. coli strains isolated during this period and related drug susceptibility test was conducted by using VITEK-60 automatic microbio analyzer and K-B agar diffusion method. Results Totally 405 strains of E. coli producing ESBLs were isolated from 771 urine samples(52.5%). The strains were mainly isolated from the departments of urology, internal medicine and nephropathy, accounting for60.0% of the total. The isolation rate of ESBLs positive E. coli increased from 44.2% in 2007 to 61.2% in 2011(P0.01). The resistance rates of E. coli to common antibiotics were in upward trend, especially for the 3rd and 4th generation cephalosporin. The drug resistance rates of ESBLs positive strains to 16 antibiotics, including ampicillin, cefazolin and ceftazidime, were higher than ESBLs negative strains. Conclusion E. coli infection in urinary tract showed increased resistance to cephalosporin year by year, the detection rate of ESBLs producing strains with multi drug resistance were in increase. Clinicians should pay attention to the rational use of antibiotics.

     

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