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目的探讨2008-2014年1239株大肠埃希菌的医院感染状况并进行耐药情况分析。方法对2008-2014年分离的大肠埃希菌1239株,选用25种抗菌药物进行药敏试验。结果大肠埃希菌感染临床分布以痰液为主,为84.1%,其次为血液和尿液,分别为4.1%和3.9%。从病区来看,以肾内科的检出率最高21.9%,其次为呼吸内科16.5%。从耐药率来看,总耐药率最高的为氨苄西林91.8%,其次为哌拉西林89.0%,复方新诺明87.9%。对大肠埃希菌高度敏感的抗菌药物为碳青霉烯类的亚胺培南,美罗培南,分别为1.6%和1.9%。产超广谱β-内酰胺酶菌株总阳性率为53.3%,近三年有上升趋势,且差异有统计学意义。结论针对大肠埃希菌日益严重的耐药情况,在临床工作中,规范抗菌药物合理应用,减少耐药菌株的产生。
Objective To investigate the status of nosocomial infections in 1239 Escherichia coli strains from 2008 to 2014 and analyze their drug resistance. Methods 1239 strains of Escherichia coli isolated from 2008 to 2014 were selected and 25 antibacterial drugs were selected for drug sensitivity test. Results The clinical distribution of Escherichia coli infection was mainly sputum, accounting for 84.1%, followed by blood and urine, accounting for 4.1% and 3.9% respectively. From the ward point of view, the highest detection rate of renal medicine 21.9%, followed by respiratory medicine 16.5%. From the resistance rate point of view, the highest rate of total resistance to ampicillin 91.8%, followed by piperacillin 89.0%, Cotrimoxazole 87.9%. Antibacterial agents highly sensitive to Escherichia coli were carbapenems, imipenem, and meropenem, at 1.6% and 1.9%, respectively. The total positive rate of producing extended-spectrum β-lactamase strains was 53.3%, and there was an upward trend in the recent three years with a statistically significant difference. Conclusion In view of the increasingly serious drug resistance of Escherichia coli, we should standardize the rational use of antibacterials in clinical work and reduce the production of drug-resistant strains.