CAJ | 학술논문

目的：分析医院2012年1月～2014年12月分离的产β-内酰胺酶（ESBLs）大肠埃希菌临床分布与耐药性，为临床合理使用抗菌药物提供依据。方法住院患者中分离1587株大肠埃希菌进行回顾性分析，采用珠海迪尔公司微生物鉴定仪进行鉴定和药敏试验，用表型确证实验检测 ESBLs。结果1587株大肠埃希菌中检出产 ESBLs 菌株为901株（56.8％），主要分布科室为泌尿外科、内分泌科、呼吸科；标本来源主要分布为尿液609株（47.3％），痰液411株（31.9％），血液83株（6.5％）；产 ESBLs 菌株大肠埃希菌对亚胺培南耐药率为0；对青霉素类、头孢菌素类的耐药性＞90.0％，对左旋氧氟沙星、环丙沙星耐药性＞70.0％；对阿莫西林／克拉维酸、替卡西林／克拉维酸、哌拉西林／他唑巴坦、阿米卡星耐药率较低＜7.7％。结论近3年医院临床分离的大肠埃希菌耐药性呈逐年增高趋势，产超广谱β-内酰胺酶（ESBLs）大肠埃希菌检出率逐年升高，表现为多耐药，因此，加强耐药性检测和监测，对指导合理使用抗菌药物非常重要。
목적：분석의원2012년1월～2014년12월분리적산β-내선알매（ESBLs）대장애희균림상분포여내약성，위림상합리사용항균약물제공의거。방법주원환자중분리1587주대장애희균진행회고성분석，채용주해적이공사미생물감정의진행감정화약민시험，용표형학증실험검측 ESBLs。결과1587주 대 장 애 희 균 중 검 출 산 ESBLs 균주위901주（56.8％），주요분포과실위비뇨외과、내분비과、호흡과；표본래원주요분포위뇨액609주（47.3％），담액411주（31.9％），혈액83주（6.5％）；산 ESBLs 균주대장애희균대아알배남내약솔위0；대청매소류、두포균소류적내약성＞90.0％，대좌선양불사성、배병사성내약성＞70.0％；대아막서림／극랍유산、체잡서림／극랍유산、고랍서림／타서파탄、아미잡성내약솔교저＜7.7％。결론근3년의원림상분리적대장애희균내약성정축년증고추세，산초엄보β-내선알매（ESBLs）대장애희균검출솔축년승고，표현위다내약，인차，가강내약성검측화감측，대지도합리사용항균약물비상중요。
Objective To analyze the β-lactamases-producing Escherichia coli which were isolated from hospital specimens from Jun 2012 to Dec 2014,and provide a more accurate evidence to guide drug-selecting for antibacterial use.Methods An-alyzed 1 587 E.coli from patient sample selected between Jun 2012~Dec 2014 using the microbial analysis system manufac-tured by ZHUHAI DL BIOTECH CO.LTD,A phenotypic test was also conducted to test ESBLs.Results 1 587 stains of E-.coli were isolated,which counted for 23.9% of the specimens;901 stains (56.8%)out of total 1 587 stains appeared to be ESBLs-producing E.coli,and others were non-ESBLs-producing E.coli.The 1 587 Escherichia coli mainly came from De-partment of Urology (408,weight 25.7%),Department of Endocrinology (271,weight 17.1%),Department of Respiration (249,weight 15.7%).Rine specimen contributed 609 stains (47.3%),411 E.coli stains (31.9%)were discovered in spu-tum samples,and 83 stains (6.5%)showed in blood samples.The resistance to imipenem were discovered in the analysis. The rates of resistance to penicillins,cephalosporins were over 90.0%,the rates of resistance to Levofloxacin,ciprofloxacin were above 70.0%,and resistance rates to amoxicillin-clavulanic acid,Ticarcillin-clavulanic acid,piperacillin/tazobactam, amikacin were lower than 7.7%.Conclusion The drug-resistance of the E.coli were increasing over the past three years. There was a significant portion of MDR and PDR present in the trend.Thus,the reinforcement of the drug-resistance survey and testing have a far-reaching meaning to promote rational drug selecting.