摘要
目的:探究某综合医院大肠埃希菌对常见抗菌药物的耐药性变化趋势。方法:对2016年1月~2019年12月该院检出的大肠埃希菌进行回顾性调查分析,采用VITEK-2 Compact全自动微生物鉴定系统进行细菌鉴定,药敏试验采用K-B纸片扩散法。数据采用WHONET5.6和SPSS20.0软件进行分析。结果:2016~2019年768株大肠埃希菌对厄他培南、妥布霉素、头孢吡肟、庆大霉素、氨苄西林/舒巴坦,每种药物4年间的耐药率差异有统计学意义(P<0.05);而其他药物耐药率差异无统计学意义(P>0.05)。2016~2019年产超广谱β-内酰胺酶(ESBLs)菌株的检出率分别为48.40%,50.80%,43.23%,43.78%;4年间产ESBLs菌株的检出率基本稳定(χ^(2)=3.088,P=0.378)。2016~2019年产ESBLs的大肠埃希菌对常用抗菌药物的耐药率分析显示,妥布霉素、头孢吡肟、头孢他啶、庆大霉素、氨曲南、头孢曲松,每种药物4年间耐药率差异有统计学意义(P<0.05);而其他药物耐药率差异无统计学意义(P>0.05)。4年来产ESBLs与非产ESBLs大肠埃希菌对亚胺培南、哌拉西林/他唑巴坦、庆大霉素、复方新诺明、妥布霉素、头孢吡肟、头孢他啶、氨曲南、左氧氟沙星、环丙沙星、氨苄西林/舒巴坦、头孢曲松、氨苄西林的耐药率的差异有统计学意义(P<0.05);其他抗菌药物两者的耐药率差异无统计学意义(P>0.05)。结论:本院大肠埃希菌对多种常用抗菌药物的耐药率较高,产ESBLs的大肠埃希菌耐药形势复杂且呈现多重耐药,各临床科室应根据药敏结果合理选择抗菌药物,避免经验用药造成耐药菌的产生和传播。
Objective:To explore the change trend of Escherichia coli resistance to common antibacterial drugs in a general hospital.Methods:Retrospective investigation and analysis were conducted on E.coli detected in the hospital from January 2016 to December 2019.The strains were identified by the auto-matic microoranism analyzer VITEK-2 compact.The Bacteria drug susceptibility was performed by K-B method.The data were analyzed by WHONET5.6 and SPSS20.0 software.Results:There were statistically significant differences in drug resistance rates of 768 strains of E.coli to ertapenem,tobramycin,cefepime,genamicin,ampicillin/sulbactam during 2016 to 2019(P<0.05).There was no statistical significance in drug resistance rate of other drugs(P>0.05).The detection rates of ESBLs in 2016-2019 were 48.40%,50.80%,43.23%,43.78%,respectively.The detection rate of ESBL-producing strains was basically stable(χ^(2)=3.088,P=0.378)during 4 years.Drug resistance rate analysis of ESBLs of E.coli from 2016 to 2019 showed that drug resistance rates of tobramycin,cefepime,ceftazidime,genamicin,amtronam and ceftriaxone had statistical significance in each drug during 4 years(P<0.05).There was no statistical significance in drug resistance rate of other drugs(P>0.05).There were statistically significant differences in drug resistance rates between producing and non-producing ESBLs E.coli to imipenem,piperacillin/tazobactam,gentamicin,cotrimoxazole,tobramycin,cefepime,ceftazidime,amtronam,levofloxacin,ciprofloxacin,ampicillin/sulbactam,ceftriaxone and ampicillin during 4 years(P<0.05).Conclusion:E.coli in this hospital has a high rate of drug resistance to a variety of commonly used antibacterial drugs.ESBL-producing E.coli has a complex drug resistance situation and presents multiple drug resistance.All clinical departments should rationally select antibacterial drugs according to drug sensitivity results to avoid the generation and spread of drug-resistant bacteria caused by empirical drug use.
作者
冯宁
宋来春
郭振伟
赵丽
FENG Ning;SONG Lai-chun;GUO Zhen-wei(School of Public Health,Shandong University,Shandong Jinan 250012)
出处
《医学检验与临床》
2021年第10期31-35,19,共6页
Medical Laboratory Science and Clinics
关键词
大肠埃希菌
抗菌药物
超广谱Β-内酰胺酶
耐药性
合理用药
Escherichia coli
Antimicrobial agents
Extended spectrum beta-lactamases
Drug resistance
Rational drug use
