不同类型尿路感染大肠埃希菌的分布和耐药性分析

doi:10.3969/j.issn.1006-298X.2018.06.004

肾脏病与透析肾移植杂志 ›› 2018, Vol. 27 ›› Issue (6): 518-522.DOI: 10.3969/j.issn.1006-298X.2018.06.004

不同类型尿路感染大肠埃希菌的分布和耐药性分析

出版日期:2018-12-28 发布日期:2019-01-21

Analysis of distribution and drug resistance of Escherichia coli in different urinary tract infection

Online:2018-12-28 Published:2019-01-21

摘要/Abstract

摘要：

目的：了解2014年～2016年本地区尿路感染患者大肠埃希菌的分布和耐药性特点。
方法：回顾分析复旦大学附属华东医院肾内科3年间1 034例住院患者的菌尿记录和药敏试验结果，分为非复杂感染组和复杂尿路感染两组，计算两组大肠埃希菌的构成比及药物敏感率，了解两组病例大肠埃希菌的分布和耐药性特点。
结果：非复杂感染组和复杂感染组在平均年龄及性别方面未见差异。非复杂感染组3年大肠埃希菌的构成比无差异（484%、381%、427%），抗生素敏感率无差异。复杂感染组3年大肠埃希菌的构成比无差异（320%、258%、352%），对头孢哌酮/舒巴坦的敏感率呈逐年降低趋势（875% vs 634% vs 426%，P＜005）。与非复杂感染组相比，复杂感染组大肠埃希菌的构成比较低（312% vs 423%，P＜005），对阿米卡星、左氧氟沙星、头孢唑啉、头孢呋辛、头孢吡肟、头孢他啶、头孢哌酮/舒巴坦的敏感率均较低，尤其对头孢哌酮/舒巴坦的敏感率明显降低（589% vs 915%，P=0000）。
结论：本地区3年的复杂尿路感染患者大肠埃希菌的构成比较低，且耐药谱增宽、耐药程度加剧，临床应根据药敏试验结果合理使用抗生素以减少耐药菌株的产生和扩散。

关键词: 尿路感染, 大肠埃希菌, 耐药性

Abstract:

Ｏｂｊｅｃｔｉｖｅ：To analyze the distribution and drug resistance of Escherichia coli(E. coli) in patients with urinary tract infection and to provide guidance for reasonable applications of antibiotics in clinic.
Ｍｅｔｈｏｄｏｌｏｇｙ：A retrospective survey was carried out in significant bacteriuria records and their drug sensitive test results taken by microbiology laboratory of Huadong Hospital from year 2014 to 2016 in 1 034 patients with urinary tract infection.All the patients were divided into uncomplicated or complicated urinary tract infection group.The constituent ratio and drug sensitive rate of E.coli among each group in total and per year were calculated.Then we can obtain the characteristics of E.coli distribution and drug resistance among each through comparing within and between groups.
Ｒｅｓｕｌｔｓ：There was no difference in age and sex between uncomplicated group and complicated infection groups.The constituent ratios of E.coli in uncomplicated group of the year 2014,2015 and 2016 were 484%,381% and 427%,respectively,and there was no difference in the 3 years constituent ratio and antibiotic susceptibility.The constituent ratios of E.coli in complicated group of the year 2014,2015 and 2016 were 320%,258% and 352%,respectively,and there was no difference in the 3 years constituent ratioandantibiotic susceptibility except the susceptibility to cefoperazone/sulbactam was decreasing year by year(875% vs 634% vs 426%,P<005). Compared to the uncomplicated group,the total constituent ratio of E.coli in complicated group was significantly lower (312% vs 423%,P<005) and the sensitivity to amikacin,levofloxacin,cefazolin,cefuroxime,cefepime,ceftazidime and cefoperazone/sulbactam were also lower,especially the sensitivity to cefoperazone/sulbactam was significantly reduced (589% vs 915%，P=0000)
Ｃｏｎｃｌｕｓｉｏｎ：
Compared to the uncomplicated group,the total constituent ratio of E.coli in complicated group was lower and the drug resistance spectrum was more significant and less sensitive to antibities.The effective choice of antibiotics is highly recommended based on the result of drug sensitive test,in order to avoid emerging and spreading of drugresistant pathogens in clinic.

Key words: urinary tract infection, Escherichia coli, drug resistance

柳文毅，张晓丽，叶志斌，等. 不同类型尿路感染大肠埃希菌的分布和耐药性分析[J]. 肾脏病与透析肾移植杂志, 2018, 27(6): 518-522.

LIU Wenyi，ZHANG Xiaoli，YE Zhibin，et al. Analysis of distribution and drug resistance of Escherichia coli in different urinary tract infection[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2018, 27(6): 518-522.

[1]	杨丽，龚妮容，刘宏发，等. 腹膜透析相关性腹膜炎的细菌谱及耐药性分析[J]. 肾脏病与透析肾移植杂志, 2018, 27(6): 513-517.
[2]	邹佳楠\| 叶志斌. 糖尿病患者尿路感染的危险因素及致病菌分析[J]. 肾脏病与透析肾移植杂志, 2014, 23(2): 179-182.

ISSN 1006-298X CN 32-1425/R

不同类型尿路感染大肠埃希菌的分布和耐药性分析

Analysis of distribution and drug resistance of Escherichia coli in different urinary tract infection

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