【摘要】 目的分析2005-2007年3年间温州医学院附属第一医院住院患者血液中大肠埃希菌的检出率,研究其对常用抗菌药物的耐药情况及其产超广谱β-内酰胺酶(extended-spectrum β-lactamases,ESBLs)菌株的耐药特性,为临床用药提供参考。方法用BacT/ALERT3D血培养仪进行血液培养,VITEK-60系统、GNI+卡、GNS-143卡进行菌种鉴定、ESBLs检测和药敏试验。结果3年间送检的9513份血培养标本中,检出132株大肠埃希菌,其中产ESBLs菌株67株,检出率为50.8%,明显高于非产ESBLs菌,其对β-内酰胺类药物100%耐药,对喹诺酮类、氨基糖苷类、磺胺类药物耐药性高,对哌拉西林/他唑巴坦、呋喃妥因耐药率分别为6.0%,9.0%;所有受试菌对亚胺培南均敏感。结论产ESBLs菌的检出率高,血液中感染大肠埃希菌对常用抗菌药物的耐药性日益严重;要重视ESBLs的检测,治疗时应根据药敏结果选择抗菌药物。更多还原

【Abstract】 Objective To analyze the infection rate,drug resistance of the Escherichia coli and the drug resistance of extended-spectrum β-lactamases(ESBLs)-producing strain in the blood of the hospitalized patients from 2005 to 2000,provide the reference for clinical antibiotics use.Methods Blood were cultured with BacT/ALERT 3D,antibiotics susceptibility and ESBLs-producing strain were detected with Vitek-60,GNI+and GNS-143.Results A total of 132 strains of Escherichia coli were detected from the 9513 samples with 67 ESBLs-producing strains,the detection rate of ESBLs-producing strain was 50.8%.The antibiotic resistance rate of ESBLs-producing strain were much higher than that of non-ESBLs-producing strain.The resistance rate of ESBLs-producing strain toβ-lactam antibiotics was 100%,and the resistant rates to quinolones,aminoglycosides and sulfonamides were very high.The resistance rates to cefotetan,piperacillin/tazobactam were 6.0%and 9.0%respectively,all strains were sensitive to imipenem.Conclusion Drug resistance of Escherichia coli in blood was serious,and the detection rates of ESBLs-producing strain were high,the antibiotics used in clinical treatment should be chosen according to the results of drug susceptibility test and ESBLs detection.更多还原