中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2011年
16期
54-56
,共3页
赵崇高%谢顺清%简雪峰%郭天然
趙崇高%謝順清%簡雪峰%郭天然
조숭고%사순청%간설봉%곽천연
耐药率%产超广谱β -内酰胺酶%大肠埃希氏菌
耐藥率%產超廣譜β -內酰胺酶%大腸埃希氏菌
내약솔%산초엄보β -내선알매%대장애희씨균
Antibiotic resistance%ESBLs - producing%Escherichia Coli
目的 分析河南科技大学第一附属医院大肠埃希氏菌的科室分布及耐药情况,为控制和预防该菌的感染及指导临床用药提供依据.方法 分析2009年1月至2009年12月临床患者的标本,采用WHONET 5.4软件进行统计分析.结果 390株大肠埃希氏菌主要分布在泌尿内科,其次是呼吸内科；产酶率最高的科室是ICU,其次是呼吸内科.大肠埃希氏菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南保持较高的敏感性,对头孢唑啉、氨苄西林、复方新诺明、环丙沙星、庆大霉素的耐药率＞50％；而产超广谱β -内酰胺酶(ESBLs)大肠埃希氏菌菌株除对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亚胺培南有较高的敏感性外,对广谱β -内酰胺类抗生素的耐药率均高于非产ESBLs大肠埃希氏菌(P＜0.05),特别是产ESBLs大肠埃希氏菌对头孢噻肟、头孢三嗪的耐药率高达80％,与头孢他啶、曲氨南的耐药率相比差异有统计学意义(P＜0.05).结论 大肠埃希氏菌耐药严重,特别是产ESBLs大肠埃希氏菌耐药非常严重,临床应重视病原菌的检测,根据药敏结果制定最佳治疗方案,并采取有效措施控制产ESBLs大肠埃希氏菌在医院内的定植和播散.
目的 分析河南科技大學第一附屬醫院大腸埃希氏菌的科室分佈及耐藥情況,為控製和預防該菌的感染及指導臨床用藥提供依據.方法 分析2009年1月至2009年12月臨床患者的標本,採用WHONET 5.4軟件進行統計分析.結果 390株大腸埃希氏菌主要分佈在泌尿內科,其次是呼吸內科；產酶率最高的科室是ICU,其次是呼吸內科.大腸埃希氏菌對頭孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亞胺培南保持較高的敏感性,對頭孢唑啉、氨芐西林、複方新諾明、環丙沙星、慶大黴素的耐藥率＞50％；而產超廣譜β -內酰胺酶(ESBLs)大腸埃希氏菌菌株除對頭孢哌酮/舒巴坦、哌拉西林/他唑巴坦、亞胺培南有較高的敏感性外,對廣譜β -內酰胺類抗生素的耐藥率均高于非產ESBLs大腸埃希氏菌(P＜0.05),特彆是產ESBLs大腸埃希氏菌對頭孢噻肟、頭孢三嗪的耐藥率高達80％,與頭孢他啶、麯氨南的耐藥率相比差異有統計學意義(P＜0.05).結論 大腸埃希氏菌耐藥嚴重,特彆是產ESBLs大腸埃希氏菌耐藥非常嚴重,臨床應重視病原菌的檢測,根據藥敏結果製定最佳治療方案,併採取有效措施控製產ESBLs大腸埃希氏菌在醫院內的定植和播散.
목적 분석하남과기대학제일부속의원대장애희씨균적과실분포급내약정황,위공제화예방해균적감염급지도림상용약제공의거.방법 분석2009년1월지2009년12월림상환자적표본,채용WHONET 5.4연건진행통계분석.결과 390주대장애희씨균주요분포재비뇨내과,기차시호흡내과；산매솔최고적과실시ICU,기차시호흡내과.대장애희씨균대두포고동/서파탄、고랍서림/타서파탄、아알배남보지교고적민감성,대두포서람、안변서림、복방신낙명、배병사성、경대매소적내약솔＞50％；이산초엄보β -내선알매(ESBLs)대장애희씨균균주제대두포고동/서파탄、고랍서림/타서파탄、아알배남유교고적민감성외,대엄보β -내선알류항생소적내약솔균고우비산ESBLs대장애희씨균(P＜0.05),특별시산ESBLs대장애희씨균대두포새우、두포삼진적내약솔고체80％,여두포타정、곡안남적내약솔상비차이유통계학의의(P＜0.05).결론 대장애희씨균내약엄중,특별시산ESBLs대장애희씨균내약비상엄중,림상응중시병원균적검측,근거약민결과제정최가치료방안,병채취유효조시공제산ESBLs대장애희씨균재의원내적정식화파산.
Objective To analyze the department distribution and drug resistance of Escherichia coli andprovide basis for controlling and preventing the bacteria.Methods Analyzing the clinical specimens during the whole year in 2009 and getting their statistical analysis by WHONET 5.4.Results Three hundred and ninety strains of Escherichia coli were collected,the great majority of them were mainly distributed in department of urlolgy,which was followed by respiratory department.The highest rate of enzyme production was in ICU,which was followed by respiratory department.The survey showed that Escherichia coli maintained higher sensitivity to Cefoperazone/Sulbactam,Piperacillin/Tazobactam and Imipenem.The survey also showed that the rate of Escherichia coli' s antibiotic resistance which was related to Cefazolin,Ampicillin Sodium,Compound Sulfamethoxazole,Ciprofloxacin and Gentamicin was more than 50％.Extended spectrum β - lactamases E.coli has not only higher sensitivity to Cefoperazone/Sulbactam,Piperacillin/tazobactam and Imipenem but also higher rate of antibiotic resistance to broad - spectrum β - lactam antibiotics than non - extended spectrum β - lactamase E.coli ( P ＜0.05),especially its rate of antibiotic resistance to cefotaxime and ceftriaxone is up to 80％ and it has significant difference in antibiotic resistance with Aztreonam( P ＜ 0.05).Conclusions Escherichia coli has the severe antibiotic resistance,extended spectrum β -lactamases E.coli has especially highest drug resistantance.Therefore,the detection of pathogenic bacteria should be emphasized in clinical practice,and the best therapeutic regimen should be established by drug sensitivity test,meanwhile,some effective measures should be adopted to control the colonization and dissemination of extended spectrum β -lactamases E.coli in hospital.
