【摘要】 目的观察大肠埃希菌碳青霉烯异质性耐药(CHEC)的流行病学特征,探讨大肠埃希菌异质性耐药感染的影响因素,为临床合理应用抗菌药物提供理论依据。方法收集临床标本分离的大肠埃希菌株,进行超广谱β-内酰胺酶(ESBLs)检测、典型碳青霉烯异质性耐药大肠埃希菌检测、菌落谱型分析(PAP),同时对耐药谱进行分析,确证大肠埃希菌碳青霉烯异质性耐药的影响因素。结果 200株大肠埃希菌主要分离自尿液、血液和痰液标本,检出率分别占16.50%、20.50%和38.00%。该菌对美罗培南、厄他培南和亚胺培南的异质性耐药率分别为6.00%、20.50%和29.00%。细菌产ESBLs、慢性基础病、先前使用抗生素和侵袭性医疗操作是碳青霉烯异质性耐药大肠埃希菌感染的主要影响因素。结论大肠埃希菌中碳青霉烯异质性耐药现象非常严重,特别是细菌产ESBLs、抗生素使用和侵袭性医疗操作与碳青霉烯异质性耐药有关。因此,临床应合理使用抗菌药物,规范侵袭性医疗操作,可避免院内感染的暴发流行。更多还原

【Abstract】 Objective To observe the epidemiological characteristics of Carbapenems heteroresistant Escherichia coli(CHEC),and to explore the influencing factors of infection by Escherichia coli with Carbapenems heteroresistance,so as to provide evidences for the rational use of antimicrobial agents in clinical practice.Methods TheEscherichia colistrains isolated from clinical samples were collected.Then the Extended Spectrum Beta-Lactamases(ESBLs)detection,typical Carbapenems heteroresistant Escherichia coli detection and Population Analysis Profile(PAP)were performed.Drug resistant profile was analyzed at the same time.We confirmed the influencing factors of Carbapenem heteroresistant Escherichia coli. Results The 200 Escherichia coli strains were mainly isolated from urine,blood and sputum samples.The detection rates from urine,blood and sputum samples were 16.50%,20.50% and 38.00%,respectively.In these Escherichia coli strains,the rates of heteroresistant to meropenem and ertapenem and imipenem were 6.00%,20.50%and 29.00%,respectively.Bacteria producing ESBLs,chronic basic diseases,pre-use of antibiotics and invasive medical practices were the main influencing factors for CHEC infection. Conclusion The phenomenon of Carbapenems heteroresistance in Escherichia coli is very serious,especially the Carbapenems heteroresistance is associated with bacteria producing ESBLs,antibiotic use and invasive medical practices.Therefore,the rational use of clinical antimicrobial agents and standardizing the invasive medical practices can avoid the nosocomial infection outbreak and prevalence.更多还原