【作者】 储从家； 孔繁林； 王树坤； 吴惠玲；

【Author】 Chu Congjia~1,Kong Fanglin~1,Wang Shukun~2,Wu Huilin~1 (1.People’s Hospital of Yuxi City,Yuxi 653100,Yunnan;2.Center for Disease Control and prevention of Yuxi City)

【机构】 玉溪市人民医院检验科； 玉溪市疾病预防控制中心；

【摘要】 目的探讨需氧和厌氧配对血培养分离大肠埃希菌的情况及其耐药性。方法使用mini vITAL或BacT/ALERT 3D血培养仪对2001年1月-2008年6月临床送检血液标本进行需氧和厌氧配对培养分离菌株,用VIrEK 32分析系统及配套的鉴定及药敏卡进行细菌鉴定、药敏试验及ESBLS检测。结果共分离出149株大肠埃希菌,其中需氧和厌氧培养均生长115株占77.18%(115/149),仅需氧培养生长14株占9.40%(14/149),仅厌氧培养生长20株占13.42%(20/149),产ESBLS阳性率36.91%(55/149)。该菌对亚胺培南、呋喃妥因、头孢西丁、奈替米星有较高的敏感率,分别为1 00.00%、94.6 3%、88.60%和75.84%,对氨苄西林、阿莫西林/棒酸、头孢噻吩、头孢噻肟、头孢他啶、庆大霉素、奈啶酸、培氟沙星、复方新诺明、替卡西林、妥布霉素的抗性率均大于40.00%。结论采用需氧和厌氧配对培养可提高大肠埃希菌阳性检出率,只做厌氧或需氧培养将有9.40%或13.42%阳性被漏检:该地区血源性大肠埃希菌产ESBLS率较高,对大多数抗菌药物耐药且呈多重耐药,需高度重视,治疗可首选亚胺培南和头孢西丁等药物。更多还原

【Abstract】 Objective To understand the detection and antimicrobial susceptibilities of Escherilia coli strains isolated from paired aerobic and anaerobic bottles culture.Methods Compared the yield and antimicrobial susceptibilities of Escherilia coli from clinical blood samples between January 2001 and June 2008 by the mini VITAL and BacT/ALERT 3D system(bioMerieus,France).All isolates following subculture were identified and detected by identified and antimicrobial susceptibility cards(Automatic Microorganism Identification System VTTEK 32 GNI+,GNS,bioMdrieus,France).Results A total of 149 Escherilia coli strains were recovered,of these isolates,115(77.18%) were recovered from both the aerobic and anaerobic bottles,14 (9.40%) were recovered from the aerobic bottles only,and 20(13.42%) were recovered from the anaerobic bottles only.The positive rate of ESBLS was 36.91%.The isolates exhibit a high incidence of susceptibility to imipenem,nitrofurantion,cefoxitin,and netilmicin,and the rates were 100.0%,94.63%,88.60%and 75.84%, respectively.The incidence of resistance to ampicillin,amoxicillin/clavulanic acid,cephalothin,ceotaxime, ceftazidime,gentamicin,nalidixic acid,pefloxacin,sulphamethoxazole,ticarcillin,tobramycin were more than 40%.Conclusions The overall recovery of Escherilia coli from both bottles exceeded that from one bottles;the increased yields in the aerobic and anaerobic bottles were 9.40%and 13.4%,respectively.The isolates exhibit a high incidence of resistance to many antibiotics and the high positive rate of ESBLS.The first-line drugs were imipenem and cefoxitin.更多还原