老年住院患者产超广谱β-内酰胺酶大肠埃希菌的检测与耐药性研究

发布时间：2018-01-15 20:21

本文关键词：老年住院患者产超广谱β-内酰胺酶大肠埃希菌的检测与耐药性研究　出处：《当代医学》2017年03期 　论文类型：期刊论文

【摘要】：目的分析老年住院发生医院感染的患者产超广谱β-内酰胺酶(ESBLs)大肠埃希菌(ESBLs-ECO)的临床分布特点及耐药性,为合理使用抗生素提供临床依据。方法回顾性分析老年住院发生医院感染患者分离出的519株ECO中产ESBLs-ECO检出率、临床分布及耐药性检测结果。结果 519株ECO共检出293株产ESBLs-ECO(56.45%),ICU、急诊科、肿瘤科检出率分别为25.94%、16.04%和13.99%,尿液、痰液和血液标本检出率分别为33.45%、20.14%和13.65%;产ESBLs-ECO对磺胺甲VA唑/甲氧苄啶耐药率最高为98.63%,对庆大霉素、哌拉西林、妥布霉素、头孢唑林耐药率均高于90%;产ESBLs-ECO与非产ESBLs-ECO对亚胺培南、阿米卡星的耐药率比较差异无统计学意义,余抗菌药物耐药率比较差异均有统计学意义(P0.05)。结论产ESBLs-ECO耐药现象严重,ICU科室检出率最高,应根据其药敏试验结果合理用药,并加强ICU住院患者监测,以减少产ESBLs-ECO感染的发生。
[Abstract]:Analysis of hospitalized elderly patients with extendedspectrum beta lactamase to nosocomial infection (ESBLs) in Escherichia coli (ESBLs-ECO) clinical distribution characteristics and drug resistance, to provide the clinical basis for the rational use of antibiotics. Methods a retrospective analysis of hospital infection in hospitalized elderly patients with isolated 519 strains of ECO producing ESBLs-ECO detection rate, clinical distribution and the drug resistance test results. Results 519 strains of ECO were detected in 293 strains of ESBLs-ECO (56.45%), ICU, emergency department, Department of tumor detection rate was 25.94%, 16.04% and 13.99%, urine, sputum and blood samples were detected in 33.45%, 20.14% and 13.65%; ESBLs-ECO of sulfamethoxazole / trimethoprim resistance was the highest rate of VA 98.63%, to gentamicin, piperacillin, tobramycin, cefazolin resistance rates were higher than 90%; ESBLs-ECO producing and non producing ESBLs-ECO to imipenem, Amikacin resistant rate there was no significant difference There was a statistically significant difference in drug resistance rate between the two antibiotics (P0.05). Conclusion the drug resistance of ESBLs-ECO is serious, and the detection rate of ICU is the highest. Rational drug use should be based on the results of drug sensitivity test, and the monitoring of ICU inpatients should be strengthened to reduce the incidence of ESBLs-ECO infection.

【作者单位】：宣城市药品不良反应监测中心;
【分类号】：R446.5
【正文快照】： 抗菌药物在临床中的广泛极为应用,这也导致不合理应用现象逐渐增多,使得细菌耐药现象不断加重,尤其是第三代头孢类抗菌药物大量应用,导致产超广谱β-内酰胺酶(ESBLs)细菌检出率呈明显提高。临床研究显示[1],住院患者尤其是老年患者是感染ESBLs-ECO的重点人群。基于此,本研究分

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