【摘要】 目的 描述产超广谱β-内酰胺酶大肠埃希菌（ultraspectrum β-lactamase Escherichia coli,ESBL-EC）的感染患者信息、临床分布等特征，分析ESBL-EC耐药情况，为医院感染防控提供依据。方法 选取2017—2022年厦门市第三医院住院患者中确诊为ESBL-EC感染的病例，收集患者及ESBLEC菌株信息，分析其感染情况、临床特征及耐药性。结果 共确诊ESBL-EC感染患者929例，社区感染与医院感染的性别、年龄比较，差异有统计学意义（P<0.001）。ESBL-EC检出率为38.52%，检出率呈逐年上升趋势（P <0.001）。ESBLEC主要来源于普外科（19.38%）。ESBL-EC主要分离自尿液（43.38%）。ESBL-EC对氨曲南、呋喃妥因、复方新诺明、头孢唑林、头孢吡肟、妥布霉素6种抗菌药物，耐药率整体呈下降趋势，差异有统计学意义（P<0.05）；对环丙沙星、头孢他啶、庆大霉素3种抗菌药物的耐药率呈上升趋势，差异有统计学意义（P<0.05）。医院感染ESBL-EC对氨苄西林、氨苄西林/舒巴坦、呋喃妥因、环丙沙星、庆大霉素、头孢菌素、妥布霉素、左氧氟沙星的耐药率均高于社区感染，差异有统计学意义（P<0.05）。结论 ESBL-EC检出率呈逐年增高的趋势。ESBL-EC耐药形势较为严峻，应加强各项感染防控措施，降低交叉感染风险；合理使用抗菌药物，减少ESBL-EC耐药菌株产生。更多还原

【Abstract】 Objective To describe the information and clinical distribution of ultra-broad spectrum β-lactamase Escherichia coli(ESBL-EC), analyze the resistance of ESBL-EC, and provide a basis for the prevention and control of nosocomial infection.Methods Patients diagnosed with ESBL-EC infection in the Third Hospital of Xiamen from 2017 to 2022 were selected to collect the information of patients and ESBL-EC strains, and analyze their infection status, clinical characteristics and drug resistance. Results A total of 929 patients with ESBL-EC infection were diagnosed,and the gender and age differences between community infection and hospital infection were statistically significant(P<0.001).The detection rate of ESBL-EC was 38.52%, and the detection rate showed an increasing trend year by year(P<0.001). The ESBLEC was mainly derived from the general surgery department(19.38%). The ESBL-EC was mainly isolated from urine(43.38%).In ESBL-EC against aztreonam, nitrofurantoin, cotrimoxazole,cefepime, and tobramycin, the resistance rate decreased, the difference was statistically significant(P<0.05). The resistance rate to ciprofloxacin, ceftazidime and gentamicin showed an increasing trend, and the difference was statistically significant(P<0.05). The resistance rate of ESBL-EC to ampicillin,ampicillin/sulbactam, nitrofurantoin, ciprofloxacin, gentamicin,cephalosporin, tobramycin, and levofloxacin were higher than those of the community infection, the difference was statistically significant(P<0.05). Conclusion The detection rate of ESBLEC has increased year by year. The resistance situation of ESBL-EC resistance is severe, and various infection prevention and control measures should be strengthened to reduce the risk of cross-infection; antimicrobial drugs should be rationally used reasonably to reduce the production of ESBL-EC resistant strains.更多还原