血流感染中大肠埃希菌对头孢吡肟耐药的危险因素分析

发布时间：2018-03-24 18:41

本文选题：血流感染　切入点：大肠埃希菌　出处：《基因组学与应用生物学》2017年10期

【摘要】：探讨血流感染中头孢吡肟耐药大肠埃希菌的流行病学特点及感染危险因素,为临床感染预防提供理论依据。收集2014年1月至2015年12月重庆医科大学附属第一医院血流感染标本中的71株头孢吡肟耐药大肠埃希菌作为病例组,同时选取等比例的头孢吡肟敏感大肠埃希菌作为对照组,进行病例对照研究。采用脉冲场凝胶电泳(pulsed-field gel electrophoresis,PFGE)进行分子流行病学调查,并采用卡方检验和logistic回归模型对患者病例资料进行相关危险因素分析。病例组菌株多重耐药现象严重,对喹诺酮类、氨基糖苷类、磺胺类抗生素的耐药率分别为84.5%、64.8%、77.5%,明显高于对照组;PFGE结果显示耐药菌株间不存在克隆传播现象;危险因素分析显示感染前手术史、引流管、头孢菌素类抗生素使用和产ESBLs是其独立危险因素。因此,建议医院加强该类细菌的监管和防控,减少相关侵入性操作,避免滥用抗生素,从而减少头孢吡肟耐药菌株的产生与流行。
[Abstract]:To investigate the epidemiological characteristics and infection risk factors of cefepime resistant Escherichia coli in blood stream infection. From January 2014 to December 2015, 71 strains of cefepime resistant Escherichia coli from the first affiliated hospital of Chongqing Medical University were collected as the case group. A case control study was carried out with cefepime sensitive Escherichia coli as control group. Pulse field gel electrophoresis (pulsed-field gel electrophoresistics) was used to investigate the molecular epidemiology of Escherichia coli. The risk factors were analyzed by chi-square test and logistic regression model. The multidrug resistance of the strains in the case group was serious, and the quinolones and aminoglycosides were detected. The drug resistance rates of sulfanilamide antibiotics were 84.5% and 64.88%, respectively, which were significantly higher than that of the control group (PFGE), the results showed that there was no clone transmission among the resistant strains, and the risk factor analysis showed that the history of operation before infection and the drainage tube. The use of cephalosporins and the production of ESBLs are independent risk factors. Therefore, it is suggested that hospitals should strengthen the supervision and control of these bacteria, reduce the invasive operation and avoid the abuse of antibiotics. In order to reduce the incidence and prevalence of cefepime resistant strains.
【作者单位】：重庆医科大学;重庆医科大学附属第一医院;
【基金】：国家自然科学基金面上项目(81471992)资金资助
【分类号】：R446.5

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