摘要
目的调查不同级别医院和不同地区医院临床分离的大肠埃希菌对常用抗生素的耐药性，并比较菌株问耐药率的差别。方法药物敏感性试验肉汤最低抑菌浓度（MIC）测定法，WHONET5软件进行结果分析。结果107株大肠埃希菌临床分离株（北京302医院35株，武汉同济医院29株，湖北县级医院33株）的MIC结果显示，全部107株大肠埃希菌未发现对亚胺培南和复方磺胺甲恶唑的耐药株，其次阿米卡星、头孢他啶的耐药率较低，含酶的复合制剂可增加B内酰胺类抗生素的抗菌活性。对环丙沙星和左氧氟沙星的耐药率均高于55％。县级医院分离菌株对头孢唑林的耐药率低于二所三甲医院为24．2％，对氯霉素的耐药率为27.3％低于武汉同济医院的55．2％。302医院、武汉同济医院和县级医院产ESBL菌株的检出率分别为25．7％、27．6％和6．1％。湖北县级医院大肠埃希菌临床分离株以哌拉西林、庆大霉素和环丙沙星三重耐药株为主，而其他二家三甲医院的大肠埃希菌临床分离株在哌拉西林、庆大霉素和环丙沙星外又增加了头孢噻肟耐药。结论不同级别医院分离的大肠埃希菌耐药率存在差异，了解耐药率问的区别对于合理使用抗菌药物是非常有意义的。
Objective To investigate and compare the antimicrobial resistance of Escherichia coli isolates collected from hospitals with different level and regions. Methods Minimal Inhibitory Concentration （MIC） test was used to study the antimicrobial resistance, and WHONET 5 was applied for analysis of the antimicrobial resistance. Results Total 107 strains of E. coli were collected from hospitals and the isolates were most susceptible to imipenem, next to ceftazidime and amikacin. β-actarn/β-lactamase inhibitor combinations can increase the activities. The rates of resistance of the strains of E. coil to ciprofloxacin and levofloxacin were more than 55%. The resistant rate of E. coli isolates from county hospitals in Hubei province to cefazolin was 24.2%, which was less than those from both tertiary hospitals, and resistant rate to chloramphenicol was 27.3% that was less than the rate 55.2% in Tongji hospital. The incidences of extended-spectrum β-lactamase （ESBL） producing strains from NO.302 hospital of PLA, Tongji hospital and the county hospitals were 25.7% and 27.6%, and 6.1% and 27.7%, respectively. Analysis of resistant profile showed that the major of multi-drug profile was piperacillin, gentamicin and ciprofloxacin with the strains in the county hospitals; otherwise, cefotaxime was added to resistant profile except the antimicrobials above in tertiary hospitals. Conclusion There were some differences in antimicrobial resistance of E. coli isolates from different level hospitals. It is significance of investigating the antimicrobial resistance of clinical isolates in different level hospitals for rational use of antimicrobial agents.
出处
《世界感染杂志》
2005年第6期468-470,共3页
World Journal of Infection
