大肠埃希菌表型分布及其耐药性分析
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刘素玲

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R378.2+1

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Phenotypes and drug resistance of clinical isolates of Escherichia coli
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    摘要:

    目的调查临床分离的大肠埃希菌产不同β内酰胺酶株分布情况、表型特征及耐药现状。方法收集某院2007年7月—2008年7月临床分离大肠埃希菌株,用VITEK 2 Compact 对其进行鉴定和17种常用抗菌药物的药敏试验,以高级专家系统软件 (AESTM)验证和解释药敏测试结果。 结果421株大肠埃希菌中,表型主要分为三类:产超广谱β内酰胺酶(ESBLs)株、产获得性青霉素酶株和野生株。产ESBLs菌株共 249株,占59.14%,其中67株为CTXM型;产获得性青霉素酶菌株120株,占28.50%;产碳青霉烯酶菌株8株,占1.90%;野生株47株,占11.16%。产酶总阳性率为88.84%(374/421)。主要标本来源为洁净中段尿,分离174株(41.33%),其次为痰标本101株(23.99%);而科室来源则比较分散,最多为肾内科39株(9.26%)。各型产酶株的耐药性有很大差异;产ESBLs仍是大肠埃希菌产生耐药性的主要原因,其对大多数β内酰胺类抗生素的耐药性明显高于产获得性青霉素酶株和野生株(P<0.05),并对大多数抗菌药物高度耐药。结论大肠埃希菌产酶率非常高,并存在多种耐药表型,其中以产ESBLs最为常见;产酶株的多重耐药和交叉耐药现象十分严重,应高度重视对产酶株的监控,合理使用抗菌药物,以控制耐药株的产生与扩散。

    Abstract:

    ObjectiveTo evaluate the distribution, phenotypes and resistance profiles of different kinds of βlactamasesproducing Escherichia coli (E. coli) isolated from clinic . MethodsE.coli isolated from a hospital  between July 2007 and July 2008 were collected, VITEK 2 Compact was used to identify and perform antimicrobial susceptibility test, phenotypes were determined by AESTM (Advanced Expert System) of VITEK 2 Compact. ResultsAmong 421 collected isolates, 249 (59.14%)  were extendedspectrum βlactamasesproducing (ESBLs) strains, including 67 CTXMproducing isolates; 120 (28.50%) were acquiredpenicillinaseproducing isolates; 8 (1.90%) were carbapenemaseproducing isolates; 47 (11.16%)   were wild type isolates. The total βlactamasesproducing rate was 88.84%(374/421). 174 (41.33%) isolates were from midportion urine,101(23.99%) were from  sputum; 39 (9.26%) isolates were from renal department, the other isolates were from the other departments.The resistant rates of various phenotypes of E.coli to most antimicrobial agents were quite different; The producing of ESBLs was the main cause of drugresistance of E.coli, the resistant rates of ESBLsproducing isolates were higher than acquiredpenicillinaseproducing isolates and wild type isolates (P<0.05) and were  highly resistant to most antimicrobial agents. Conclusionβlactamasesproducing rates of E.coli are high , and with various phenotypes, the most common phenotype is ESBLs; The multiply and cross drugresistance of ESBLsproducing isolates are serious, and the monitor should be paid attention, antimicrobial application should be used rationally, so as to control the emergence and spread of drugresistant strains.

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刘素玲,王媚,何启勇,等.大肠埃希菌表型分布及其耐药性分析[J]. 中国感染控制杂志,2009,8(2):94-97.
WANG Mei, HE Qiyong, ZHANG Liyan, et al. Phenotypes and drug resistance of clinical isolates of Escherichia coli[J]. Chin J Infect Control, 2009,8(2):94-97.

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  • 收稿日期:2008-09-23
  • 最后修改日期:2008-12-22
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  • 在线发布日期: 2009-03-30
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