摘要
目的分析血流感染产超广谱β-内酰胺酶(ESBLs)大肠埃希菌的药敏特点和危险因素,为临床诊疗和预防提供依据。方法回顾性分析商洛市中心医院111例大肠埃希菌血流感染的药敏结果和临床特点,根据大肠埃希菌是否产ESBLs分为ESBLs组和非ESBLs组,分析两组药敏结果差异,并探讨产ESBLs大肠埃希菌血流感染的危险因素。结果111株大肠埃希菌中,81株产ESBLs,占73.0%。对21种常用抗生素进行药敏实验,ESBLs组的耐药率明显高于非ESBLs组,敏感率低于非ESBLs组。ESBLs组对氨苄西林、头孢唑林、头孢曲松、头孢哌酮和头孢噻肟的耐药率超过85%,两组对阿米卡星、亚胺培南、美罗培南和哌拉西林/他唑巴坦的敏感率均超过90%。两组间比较阿莫西林/克拉维酸、四环素、哌拉西林/他唑巴坦、亚胺培南、美罗培南和阿米卡星六种药物的耐药率和敏感率差异均无统计学意义(χ^2=0.000~3.700,均P>0.5)。单因素分析显示各种置管、β-内酰胺类或酶抑制剂复合制剂使用、并发高血压三个因素在两组间差异有统计学意义(χ^2=8.066,P=0.005;χ^2=8.828,P=0.003;χ^2=4.022,P=0.045)。多因素分析显示β-内酰胺类或酶抑制剂复合制剂使用、各种置管是产ESBLs大肠埃希菌血流感染的独立危险因素(χ^2=6.703,P=0.001;χ^2=4.511,P=0.034)。结论该院血流感染大肠埃希菌ESBLs检出率和耐药率较高。患者使用β-内酰胺类或酶抑制剂复合制剂治疗和各种置管时需警惕血流感染产ESBLs大肠埃希菌的发生。
Objective To analyze the drug sensitivity and risk factors of Escherichia coli producing extended-spectrumβ-lactamases(ESBLs)in bloodstream infection,and provide the basis for clinical treatment and prevention.Methods The drug sensitivity and clinical features of 111 cases of bloodstream infection induced by Escherichia coli in Shangluo Central Hospital were analyzed retrospectively.According to whether or not to produce ESBLs divided into ESBLs and non-ESBLs groups,the differences of drug sensitivity results between the two groups were analyzed,and the risk factors of Escherichia coli producing ESBLs in bloodstream infection were investigated.Results Among 111 strains of Escherichia coli,81 strains produced ESBLs,accounting for 73.0%.Drug sensitivity test for 21 common antibiotics,the drug resistance rate of ESBLs group was significantly higher than that of non ESBLs group,and the sensitivity rate was lower than that of non ESBLs group.ESBLs group had more than 85%resistance to ampicillin,cefazolin,ceftriaxone,cefoperazone and cefotaxime,and the sensitivity of the two groups to amikacin,imipenem,meropenem,piperacillin/tazobactam were more than 90%.There were no statistically significant difference in drug resistance and sensitivity of amoxicillin/clavulanic acid,tetracycline,piperacillin/tazobactam,imipenem,meropenem and amikacin between the two groups(χ^2=0.000~3.700,all P>0.5).A single-factor analysis showed that there were significant differences between the two groups in the use of various catheterization,βimide or enzyme inhibitor compound inhibitors,and combined hypertension(χ^2=8.066,P=0.005;χ^2=8.828,P=0.003;χ^2=4.022,P=0.045).Multivariate analysis showed thatβ-lactamases or enzyme inhibitor compound inhibitors,and various catheterization were independent risk factors for Escherichia coli producing ESBLs bloodstream infection(χ^2=6.703,P=0.001;χ^2=4.511,P=0.034).Conclusion The detection rate and drug resistance rate of Escherichia coli producing ESBLs from bloodstream infection were high in this hospital.Patients withβamide or enzyme inhibitor and various catheterization should be alert to the occurrence of Escherichia coli producing ESBLs bloodstream infection.
作者
何家花
汪阔
余成强
HE Jia-hua;WANG Kuo;YU Cheng-qiang(Department of Medical Laboratory,Shangluo Central Hospital,Shaanxi Shangluo 726000,China)
出处
《现代检验医学杂志》
CAS
2021年第1期128-131,共4页
Journal of Modern Laboratory Medicine
关键词
血流感染
超广谱Β-内酰胺酶
大肠埃希菌
危险因素
bloodstream infection
extended-spectrumβ-lactamases
escherichia coli
risk factors
