高原地区100例肛周脓肿患者大肠埃希菌的耐药性变迁分析
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摘要
探讨高原地区100例肛周脓肿患者大肠埃希菌的耐药性变迁。选取2015年至2017年高原地区100例肛周脓肿患者脓液标本中分离的大肠埃希菌120株,依据年份分为15年组(n=30株)、16年组(n=42株)、17年组(n=48株),分析大肠埃希菌的耐药性变迁。15年组、16年组、17年组产超光谱β-内酰胺酶(ESBLs)菌株分别为8株(26. 67%),21株(50. 00%),34株(70. 83%),3组比较差异有统计学意义(P <0. 05);产ESBLs大肠埃希菌对氨苄西林、头孢唑啉、头孢曲松等耐药率呈逐年上升趋势,非产ESBLs大肠埃希菌对头孢曲松、氨曲南、头孢吡肟等耐药率呈逐年上升趋势;产ESBLs与非产ESBLs大肠埃希菌的耐药率比较,差异有统计学意义(P <0. 05)。高原地区100例肛周脓肿患者大肠埃希菌的耐药性在2015年至2017年期间呈逐渐上升的变迁趋势,产ESBLs与非产ESBLs大肠埃希菌的耐药性存在差异,应进行耐药性分析,以选用合理的药物进行治疗。
To discuss the changes in drug resistance of Escherichia coli in 100 patients with perianal abscess in plateau area,120 strains of Escherichia coli isolated from abscess specimens of 100 patients with perianal abscess in plateau area from 2015 to 2017 were selected. They were divided into 15 year group( n = 30 strain),16 year group( n = 42 strain) and 17 year group( n = 48 strain) based on the year. Analysis of drug resistance changes of Escherichia coli,strains of ESBLs producing in the 15,16 and 17 years groups were 8( 26. 67%),21( 50. 00%) and 34( 70. 83%) strains,respectively; there were significant differences among the three groups( P < 0. 05). The drug resistance rate of ESBLs producing Escherichia coli to ampicillin,cefazolin and ceftriaxone increased year by year and the resistance rate of Escherichia coli to ceftriaxone,aztreonam,cefepime and other non ESBLs producing strains increased year by year. Comparison of drug resistances between ESBLs and non ESBLs producing Escherichia coli,the difference was statistically significant( P < 0. 05). The drug resistance of Escherichia coli in 100 patients with perianal abscess in plateau region showed a gradually increasing trend from 2015 to 2017. The drug resistance of ESBLs producing and ESBLs producing Escherichia coli is different. Drug resistance should be analyzed so as to select rational drugs for treatment.
To discuss the changes in drug resistance of Escherichia coli in 100 patients with perianal abscess in plateau area,120 strains of Escherichia coli isolated from abscess specimens of 100 patients with perianal abscess in plateau area from 2015 to 2017 were selected. They were divided into 15 year group( n = 30 strain),16 year group( n = 42 strain) and 17 year group( n = 48 strain) based on the year. Analysis of drug resistance changes of Escherichia coli,strains of ESBLs producing in the 15,16 and 17 years groups were 8( 26. 67%),21( 50. 00%) and 34( 70. 83%) strains,respectively; there were significant differences among the three groups( P < 0. 05). The drug resistance rate of ESBLs producing Escherichia coli to ampicillin,cefazolin and ceftriaxone increased year by year and the resistance rate of Escherichia coli to ceftriaxone,aztreonam,cefepime and other non ESBLs producing strains increased year by year. Comparison of drug resistances between ESBLs and non ESBLs producing Escherichia coli,the difference was statistically significant( P < 0. 05). The drug resistance of Escherichia coli in 100 patients with perianal abscess in plateau region showed a gradually increasing trend from 2015 to 2017. The drug resistance of ESBLs producing and ESBLs producing Escherichia coli is different. Drug resistance should be analyzed so as to select rational drugs for treatment.
引文
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[12]赵思敏,林萍萍,程华莉,等.产ESBLs大肠埃希菌的临床分布特征及耐药性分析[J].中华医院感染学杂志,2016,26(22):5069-5071.
[13]Leistner R,G il rntke S,Sakellariou C,et al.Bloodstream infection due to extended-spectrum beta-lactamase(ESBL)-positive K.pneumoniae and E.coli:an analysis of the disease burden in a large cohort[J].Infection,2014,42(6):991-997.
[14]夏浩海,王学敏.某县级医院2012-2014年不同临床标本分离大肠埃希菌ESBLs检出率及其耐药性[J].中国感染控制杂志,2016,15(05):327-329+333.
[15]闫丽娜,吴晓松,黄珈雯,等.我院2012年10月-2013年3月革兰阴性杆菌产ESBLs和AmpC酶检测及耐药性分析[J].中国药房,2014,25(10):896-898.
[16]刘水桂,季苏萍.医院感染产ESBLs大肠埃希菌耐药性分析[J].中国消毒学杂志,2014,31(06):645-646.
[17]牛文娟,荆菁华,朱建奎.老年患者医院感染产超广谱β-内酰胺酶大肠埃希菌的检测与耐药性研究[J].中华医院感染学杂志,2015,25(13):2903-2905.
[18]牛素平,陈炜,赵磊,等.危重症患者尿路感染大肠埃希菌的耐药性分析[J].中华医院感染学杂志,2015,25(02):315-317.
[19]李海英,王炯,白雅红.连续5年临床分离大肠埃希菌耐药性的变迁[J].中华医院感染学杂志,2015,25(03):511-513.
[20]康运凯,闫灿.综合性医院2012年大肠埃希菌的临床分布及耐药性[J].现代预防医学,2014,41(06):1089-1090+1093.
[2]Ommer A,Herold A,Berg E,et al.German S3guidelines:anal abscess and fistula(second revised version)[J].Langenbecks Arch Surg,2017,402(2):191-201.
[3]黄青兰,袁文婧,庄原,等.一株青藏高原来源的链霉菌菌株鉴定及其抑菌活性的初步分析[J].药物生物技术,2016,23(04):308-312.
[4]张学诚,张力方,王书君.肛门直肠周围脓肿的病原菌分布及耐药性分析[J].山东医药,2016,56(40):64-66.
[5]Perera A P,Howell AM,Sodergren MH,et al.A pilot randomised controlled trial evaluating postoperative packing of the perianal abscess.[J].Langenbeck S Archives Surgery,2014(4):1-5.
[6]Gao GY,Xiong WL.Comparison of clinical effects of incision and drainage and simple incision and drainage in treatment of perianalabscess[J].China Modem Doctor,2014,52(1):138.
[7]杨舟,杨琳,肖朝晖,等.重型再生障碍性贫血患者肛周脓肿治疗效果分析[J].中华医院感染学杂志,2015,25(21):4957-4958.
[8]Adamo K,Sandblom G,Brannstrom F,et al.Prevalence and recurrence rate ofperianalabscess-apopulation-based study,Sweden 1997-2009[J].Int J Colorectal Dis,2016,31(3):669-673.
[9]Ghafourian S,Sadeghifard N,Soheili S,et al.Extended spectrum beta-lactamases:definition,classification and epidemiology[J].Curr Issues Mol Biol,2014,17(5):11-22.
[10]凌宙贵,刘滨,刘卫,等.产ESBLs大肠埃希菌动态监测及耐药性分析[J].中华医院感染学杂志,2014,24(17):4174-4176.
[11]Izdebski R,Baraniak A,Fiett J,et al.KPC-like carbapenemaseproducing Enterobacteriaceae colonizing patients across Europe and Iarael[J].Antimicrob Agents Chemother,2015,57(1):309-316.
[12]赵思敏,林萍萍,程华莉,等.产ESBLs大肠埃希菌的临床分布特征及耐药性分析[J].中华医院感染学杂志,2016,26(22):5069-5071.
[13]Leistner R,G il rntke S,Sakellariou C,et al.Bloodstream infection due to extended-spectrum beta-lactamase(ESBL)-positive K.pneumoniae and E.coli:an analysis of the disease burden in a large cohort[J].Infection,2014,42(6):991-997.
[14]夏浩海,王学敏.某县级医院2012-2014年不同临床标本分离大肠埃希菌ESBLs检出率及其耐药性[J].中国感染控制杂志,2016,15(05):327-329+333.
[15]闫丽娜,吴晓松,黄珈雯,等.我院2012年10月-2013年3月革兰阴性杆菌产ESBLs和AmpC酶检测及耐药性分析[J].中国药房,2014,25(10):896-898.
[16]刘水桂,季苏萍.医院感染产ESBLs大肠埃希菌耐药性分析[J].中国消毒学杂志,2014,31(06):645-646.
[17]牛文娟,荆菁华,朱建奎.老年患者医院感染产超广谱β-内酰胺酶大肠埃希菌的检测与耐药性研究[J].中华医院感染学杂志,2015,25(13):2903-2905.
[18]牛素平,陈炜,赵磊,等.危重症患者尿路感染大肠埃希菌的耐药性分析[J].中华医院感染学杂志,2015,25(02):315-317.
[19]李海英,王炯,白雅红.连续5年临床分离大肠埃希菌耐药性的变迁[J].中华医院感染学杂志,2015,25(03):511-513.
[20]康运凯,闫灿.综合性医院2012年大肠埃希菌的临床分布及耐药性[J].现代预防医学,2014,41(06):1089-1090+1093.