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目的了解神经外科监护室(Neurosurgery Intensive Care Unit,NSICU)大肠埃希菌的分布及耐药性变迁,为临床治疗提供依据。方法分析2011年1月-2013年12月95株大肠埃希菌的分布及药敏实验结果,收集数据进行统计分析。结果 45株(47.4%)大肠埃希菌菌菌种来自痰标本,36株(37.9%)来自尿标本。2011年共检出大肠埃希菌23株,其中超广谱β-内酰胺酶(Extended Spectrum Beta-Lactamases,ESBLs)菌株9株,占39.1%,2012年共检出32株,ESBLs17株,占53.1%,2013年检出40株,ESBLs26株,占65%。2011-2013年,ESBLs阴性的大肠埃希菌对头孢他啶的耐药率分别为50%、60%和64.3%,ESBLs阳性的耐药率分别为88.9%、100.0%和100.0%,明显高于ESBLs阴性细菌;菌株总体耐药率分别为73.9%、81.3%和87.5%,呈逐年上升趋势。其余β-内酰胺类抗菌药物亦有这种趋势。目前尚未发现对碳青霉烯类抗菌药物耐药的大肠埃希菌菌株。结论大肠埃希菌对多种抗菌药物呈多药耐药性,应加强对大肠埃希菌耐药性的检测,加强医务人员的手卫生,加强对重症患者的护理,加强NSICU的消毒和管理,合理应用抗菌药物。
Objective To understand the distribution and drug resistance changes of Escherichia coli in Neurosurgery Intensive Care Unit (NSICU) and provide basis for clinical treatment. Methods The distribution and susceptibility testing results of 95 strains of Escherichia coli from January 2011 to December 2013 were analyzed. The data were collected for statistical analysis. Results 45 (47.4%) strains of Escherichia coli were from sputum and 36 (37.9%) from urine samples. In 2011, 23 strains of Escherichia coli were detected, of which 9 strains of Extended Spectrum Beta-Lactamases (ESBLs) accounted for 39.1%, 32 strains were detected in 2012, and ESBLs17 strains accounted for 53.1%, detected in 2013 40 strains, ESBLs26 strains, accounting for 65%. The resistance rate of ESBLs-negative Escherichia coli to ceftazidime in 2011-2013 was 50%, 60% and 64.3% respectively, and the positive rates of ESBLs were 88.9%, 100.0% and 100.0%, respectively, which were significantly higher than those of ESBLs Negative bacteria; The overall drug resistance rate of strains were 73.9%, 81.3% and 87.5%, showing an upward trend year by year. The remaining β-lactam antibiotics also have this trend. No strains of Escherichia coli resistant to carbapenem antibiotics have been found so far. Conclusion Escherichia coli is multi-drug resistant to many kinds of antimicrobial agents. The detection of drug-resistant Escherichia coli should be strengthened, the hand hygiene of medical staff should be strengthened, the nursing of critically ill patients should be strengthened, and the disinfection and management of NSICU should be strengthened. , Rational use of antimicrobial drugs.