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目的分析综合ICU危重症患者大肠埃希菌致尿路感染病原菌的分布特点和耐药性。方法收集2012-2014年宁波市北仑区第二人民医院128例综合ICU危重症患者大肠埃希菌致尿路感染的清洁中段尿液培养标本,分别进行细菌鉴定、药敏试验及超广谱β-内酰胺酶(ESBLs)检测。结果 128例患者共分离出大肠埃希菌128株,2012-2014年每年留置尿管患者检出的产ESBLs菌株数均多于非留置尿管患者,但差异无统计学意义(均P>0.05)。产ESBLs菌株对头孢唑林、头孢呋辛完全耐药,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和头孢替坦较为敏感,对亚胺培南的敏感性最强。产ESBLs菌株对大部分抗菌药物的耐药性均高于非产ESBLs菌株,部分耐药性的差异具有统计学意义(P<0.05)。结论大肠埃希菌产ESBLs菌株对多数抗菌药物存在较高的耐药性,但对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢替坦、亚胺培南的耐药性较低,可作为治疗大肠埃希菌致尿路感染优先抗菌药物。
Objective To analyze the distribution and drug resistance of pathogens causing urinary tract infection caused by Escherichia coli in critically ill ICU patients. Methods A total of 128 urine samples collected from 2012 to 2014 in the Second People’s Hospital of Beilun District, Ningbo City, were collected for the analysis of urinary tract infections caused by Escherichia coli in critically ill patients with ICU. Bacterial identification, drug sensitivity test and ESBLs - Lactamases (ESBLs) detection. Results A total of 128 Escherichia coli isolates were isolated from 128 patients. The number of ESBLs producing strains in indwelling catheters was higher in 2012-2014 than those in non-indwelling urinary catheters (P> 0.05, respectively) ). The strains producing ESBLs were completely resistant to cefazolin and cefuroxime and were more sensitive to cefoperazone / sulbactam, piperacillin / tazobactam and cefotetan, and were the most sensitive to imipenem. The antibiotic resistance of ESBLs-producing strains was higher than that of non-ESBLs-producing strains, and the difference of some drug resistance was statistically significant (P <0.05). Conclusion Escherichia coli producing ESBLs strains are highly resistant to most antibiotics, but resistant to cefoperazone / sulbactam, piperacillin / tazobactam, cefotetan and imipenem Lower sexual, as the treatment of Escherichia coli caused by urinary tract infections priority antibacterial drugs.