【摘要】 目的探讨尿路感染患者中大肠埃希菌耐药性及产超广谱β-内酰胺酶的情况,为临床用药提供参考。方法用半自动微生物分析仪和纸片扩散法(Kindy-Bauer法)检测大肠埃希菌及其对20种常用抗生素的耐药情况。采用纸片扩散法检测大肠埃希菌产ESBLs情况。结果 2008年3月-2011年3月尿路感染住院患者尿标本中分离出的591株大肠埃希菌中有327株产ESBLs,检出率为55.33%,产ESBLs大肠埃希菌对青霉素类抗生素耐药率高达90%以上,对复方磺胺耐药率为84.71%,对头孢菌素类抗生素的耐药率为84.40%~98.78%,对喹诺酮类抗生素耐药率为67.89%~68.81%,对氨基糖苷类耐药率为16.82%~60.86%。而不产ESBLs大肠埃希菌对青霉素类抗生素耐药率仅为39.77%~70.45%,对复方磺胺耐药率为64.02%,对头孢菌素类抗生素的耐药率为8.71%~37.88%,对喹诺酮类抗生素耐药率为40.53%~42.05%,对氨基糖苷类耐药率为7.95%~45.45%。产ESBLs大肠埃希菌对除呋喃妥因外的19种常见抗生素的耐药性显著高于不产ESBLs大肠埃希菌(P<0.05)。结论湖南省人民医院尿路感染住院患者尿标本中分离出的大肠埃希菌对20种常用抗生素耐药的主要原因是产ESBLs。细菌耐药性监测对临床合理使用抗生素有重要指导意义。更多还原

【Abstract】 Objective To explore the drug resistance of Escherichia coli and the situation of producing extended-spectrum beta-lactamases(ESBLs) in patients with urinary tract infection,and to provide the reference for clinical medication.Methods The identification of Escherichia coli and its drug-sensitivity to 20 kinds of common antibiotics were tested by Sunshine Semi-automatic Microbial Analyzer and Disk Diffusion Testing(Kindy-Bauer Testing).Results Among 591 strains of Escherichia coli isolated from urine samples of inpatients with urinary tract infection from March 2008 to March 2011,327 extended-spectrum beta-lactamases-producing strains were detected,with the detection rate of 55.33%.The drug-sensitivity to 20 kinds of common antibiotics showed that the resistance rates of ESBLs-producing E.coli to penicillin antibiotics,compound sulfanomides,cephalosporin antibiotics,quinolone antibiotics,and aminoglycoside were more than 90%,84.71%,84.40%~98.78%,67.89%~68.81%,and 16.82%~60.86%,respectively.The resistance rates of non-ESBLs-producing E.coli to penicillin antibiotics,compound sulfanomides,cephalosporin antibiotics,quinolone antibiotics,and aminoglycoside were 39.77%~70.45%,64.02%,8.71%~37.88%,40.53%~42.05%,and 7.95%~45.45%,respectively.The resistance rates of ESBLs-producing E.coli to common antibiotics were significantly higher than those of non-ESBLs-producing E.coli except nitrofurantoin(P<0.05).Conclusions Producing ESBLs is the main reason for antibiotic resistance of Escherichia coli isolated from urine samples of inpatients with urinary tract infection in Hunan Provincial People’s Hospital.It is of great value to monitor bacterial resistance for rational use of antibiotics in clinical practice.更多还原