中国感染控制杂志
中國感染控製雜誌
중국감염공제잡지
CHINESE JOURNAL OF INFECTION CONTROL
2015年
3期
170-173
,共4页
何卫平%崔恩博%王钱%鲍春梅%张文瑾%范振平%曲芬
何衛平%崔恩博%王錢%鮑春梅%張文瑾%範振平%麯芬
하위평%최은박%왕전%포춘매%장문근%범진평%곡분
血流感染%大肠埃希菌%耐药性%抗药性,微生物%抗菌药物%抗感染治疗%医院感染%合理用药
血流感染%大腸埃希菌%耐藥性%抗藥性,微生物%抗菌藥物%抗感染治療%醫院感染%閤理用藥
혈류감염%대장애희균%내약성%항약성,미생물%항균약물%항감염치료%의원감염%합리용약
bloodstream infection%Escherichia coli%drug resistance,microbial%antimicrobial agent%anti-infec-tive treatment%healthcare-associated infection%rational drug use
目的：分析某院血流感染患者标本分离的大肠埃希菌耐药性，为临床合理应用抗菌药物提供依据。方法采用 BacT／Alert 全自动血培养仪、VITEK 2细菌鉴定仪对患者血标本进行培养、鉴定；K-B 药敏纸片测定法进行药敏试验并筛选出产超广谱β-内酰胺酶（ESBLs）细菌。结果2009—2011年共分离血流感染大肠埃希菌235株， ESBLs 阳性90株，阳性率38．30％。产 ESBLs 菌株对氨苄西林、头孢噻肟、头孢曲松100％耐药；对亚胺培南／西司他丁、美罗培南敏感率均为100％，对头孢美唑、阿米卡星敏感率＞90％。非产 ESBLs 菌株耐药率最高的是氨苄西林，达70．63％；对亚胺培南／西司他丁、美 罗 培 南 敏 感 率 均 为100％，对阿米卡星、头孢噻肟、头孢美唑敏感率＞95％。产 ESBLs 菌株的耐药率均明显高于非产 ESBLs 菌株。在含有β-内酰胺酶抑制剂的复合抗菌药物中，只有头孢哌酮／舒巴坦对产 ESBLs 大肠埃希菌的敏感率＞90％，哌拉西林／他唑巴坦和替卡西林／克拉维酸的敏感率均未超过80％。结论血流感染大肠埃希菌产 ESBLs 株的耐药性较高，临床用药应根据患者感染菌的耐药情况制定合理的个体化治疗措施。
目的：分析某院血流感染患者標本分離的大腸埃希菌耐藥性，為臨床閤理應用抗菌藥物提供依據。方法採用 BacT／Alert 全自動血培養儀、VITEK 2細菌鑒定儀對患者血標本進行培養、鑒定；K-B 藥敏紙片測定法進行藥敏試驗併篩選齣產超廣譜β-內酰胺酶（ESBLs）細菌。結果2009—2011年共分離血流感染大腸埃希菌235株， ESBLs 暘性90株，暘性率38．30％。產 ESBLs 菌株對氨芐西林、頭孢噻肟、頭孢麯鬆100％耐藥；對亞胺培南／西司他丁、美囉培南敏感率均為100％，對頭孢美唑、阿米卡星敏感率＞90％。非產 ESBLs 菌株耐藥率最高的是氨芐西林，達70．63％；對亞胺培南／西司他丁、美 囉 培 南 敏 感 率 均 為100％，對阿米卡星、頭孢噻肟、頭孢美唑敏感率＞95％。產 ESBLs 菌株的耐藥率均明顯高于非產 ESBLs 菌株。在含有β-內酰胺酶抑製劑的複閤抗菌藥物中，隻有頭孢哌酮／舒巴坦對產 ESBLs 大腸埃希菌的敏感率＞90％，哌拉西林／他唑巴坦和替卡西林／剋拉維痠的敏感率均未超過80％。結論血流感染大腸埃希菌產 ESBLs 株的耐藥性較高，臨床用藥應根據患者感染菌的耐藥情況製定閤理的箇體化治療措施。
목적：분석모원혈류감염환자표본분리적대장애희균내약성，위림상합리응용항균약물제공의거。방법채용 BacT／Alert 전자동혈배양의、VITEK 2세균감정의대환자혈표본진행배양、감정；K-B 약민지편측정법진행약민시험병사선출산초엄보β-내선알매（ESBLs）세균。결과2009—2011년공분리혈류감염대장애희균235주， ESBLs 양성90주，양성솔38．30％。산 ESBLs 균주대안변서림、두포새우、두포곡송100％내약；대아알배남／서사타정、미라배남민감솔균위100％，대두포미서、아미잡성민감솔＞90％。비산 ESBLs 균주내약솔최고적시안변서림，체70．63％；대아알배남／서사타정、미 라 배 남 민 감 솔 균 위100％，대아미잡성、두포새우、두포미서민감솔＞95％。산 ESBLs 균주적내약솔균명현고우비산 ESBLs 균주。재함유β-내선알매억제제적복합항균약물중，지유두포고동／서파탄대산 ESBLs 대장애희균적민감솔＞90％，고랍서림／타서파탄화체잡서림／극랍유산적민감솔균미초과80％。결론혈류감염대장애희균산 ESBLs 주적내약성교고，림상용약응근거환자감염균적내약정황제정합리적개체화치료조시。
Objective To investigate antimicrobial resistance of Escherichia coli (E.coli )isolated from patients with bloodstream infection,and provide evidence for rational use of antimicrobial agents in clinical practice.Methods BacT/A-lert automated blood culture system and VITEK 2 automated identification system were used for bacterial culture and identi-fication.Antimicrobial susceptibility testing and detection of extended-spectrum β-lactamases (ESBLs)-producing strains were performed by Kirby-Bauer method.Results From 2009 to 2011 ,a total of 235 strains of E.coli were isolated from patients with bloodstream infection,90 (38.30%)of which were ESBLs positive strains.The resistant rates of ESBLs-producing strains to ampicillin,cefotaxime and ceftriaxone were all 100%,but susceptibility rate to imi-penem/cilastatin and meropenem were all 100%,to cefmetazole and amikacin were >90%.The resistant rate of non-ESBLs-producing strains to ampicillin was the highest (70.63%),susceptibility rate to imipenem/cilastatin and meropenem were both 100%,to amikacin,cefotaxime,and cefmetazole were all >95%.The resistant rate of ES-BLs-producing strains was significantly higher than that of the non-ESBLs-producing strains.Ofβ-lactamase inhibi-tor,only susceptibility rate of ESBLs-producing E.coli to cefoperazone/sulbactam was>90%,susceptibility rates to piperacillin/tazobactam and ticarcillin/clavulanate were both<80%.Conclusion Antimicrobial resistant rate of ESBLs-producing strains causing bloodstream infection is high,individualized treatment strategies should be made according to antimicrobial resistance of bacteria causing infection in patients.
