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[目的]对新乡地区1997～2009年13年间临床分离的儿童和成人大肠埃希菌的耐药情况进行动态监测,了解其对临床常用抗菌药物的耐药状况并进行对比分析。[方法]对13年间临床分离的大肠埃希菌标本成人4037株和儿童685株,用28种抗菌药物进行药敏试验。[结果]对儿童组和成人组大肠埃希菌高度敏感的抗菌药物为亚胺培南,美罗培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、多粘菌素等,对头胞他啶,阿米卡星、头孢吡肟耐药率较低。对其他抗菌药物尤其氨苄西林耐药率较高。成人组耐药率普遍高于儿童组,如头孢呋辛、头孢曲松及头孢吡肟、青霉素、复方新诺明、奈替米星、大部分喹诺酮类药物以及四环素等,均有统计学差异。13年来,除氯霉素耐药率下降差异显著外,大部分抗菌药物的耐药率有普遍增长趋势,且大多有统计学差异。近几年,氨苄西林、亚胺培南、左氧氟沙星耐药率下降,且有统计学差异。产超广谱β-内酰胺酶率分别为儿童组46.3%,成人组49.6%。[结论]针对儿童和成人大肠埃希菌的耐药性动态监测及变迁的区别,为提高抗菌治疗效果,对于成人的耐药率不适用于儿童,各地区应分别定期动态监测成人和儿童的耐药结果以供临床合理选用抗菌药物。
[Objective] To investigate the drug resistance status of clinical isolates of Escherichia coli in children and adults in Xinxiang from 1997 to 2009, and to find out its resistance status to commonly used antimicrobial agents. [Method] 4037 strains of Escherichia coli and 685 children were isolated from clinical isolates of Escherichia coli in the past 13 years. 28 kinds of antimicrobial agents were used for drug susceptibility testing. [Result] The antibacterials that were highly sensitive to Escherichia coli in children group and adult group were imipenem, meropenem, piperacillin / tazobactam, cefoperazone / sulbactam and polymyxin. The first methotactine, amikacin, cefepime resistance rate is low. The other antibacterials, especially ampicillin resistance rate is higher. The drug resistance rates in adults were generally higher than those in children, such as cefuroxime, ceftriaxone and cefepime, penicillin, cotrimoxazole, netilmicin, most quinolones and tetracycline, etc. . In the past 13 years, except for the significant difference in the rate of resistance to chloramphenicol, the rate of resistance to most antibiotics has generally increased, and most of them have statistical differences. In recent years, ampicillin, imipenem, levofloxacin resistance decreased, and there was a statistically significant difference. Production of extended-spectrum β-lactamase rates were 46.3% for children, adults 49.6%. [Conclusion] In order to improve the antimicrobial treatment effect, the resistance rate to adults is not suitable for children, and the dynamic monitoring and change of drug resistance of children and adults should be monitored regularly in all regions. Drug resistance for clinical use of antimicrobial drugs.