浙江医学2017，Vol.39Issue(16)：1345-1348,1352,5.DOI:10.12056/j.issn.1006-2785.2017.39.16.2016-1215
PICU产超广谱β-内酰胺酶大肠埃希菌耐药率及其与抗菌药物使用频度相关性分析
Antimicrobial resistance of extended spectrum β-lactamase Escherichia coli and its correlation with defined daily doses of antibiotics in pediatric ICU
摘要
Abstract
Objective To investigate the antimicrobial resistance of Escherichia coii producing extended spectrum β-lactamases (ESBLs) and its correlation with defined daily doses (DDDs) of antibiotics in pediatric ICU (PICU).Methods Total 102 clinical strains of Escherichia coii were identified with VITEK-2,the ESBLs were detected with double disk synergy test.The susceptibility of 70 Escherichia coii producing ESBLs to ampicillin and other antimicrobial agents was detected by broth dilution method and drug resistance genes were detected by polymerase chain reaction (PCR).Results In 102 Escherichia coii strains,ESBLs were detected in 70 cases(68.6％),in which the rates of resistance to ampicillin and cefazolin were ＞95.0％,the rates of resistance to ampicillin/sulbactam,aztreonam,cefepime,ceftriaxone,compound sulfamethoxazole,piperacillinsulbactam,tetracyclines and trimethoprim/sulfamethoxazole were all above 50.0％,the resistance to imipenem was detected in one strain.The antimicrobial resistance gene intl1 was detected in 97.1％ strains,ampC in 92.9％,tem in 62.9％,CTX-M1 in 25.7％,CTX-M3 in 37.1％,acc,DHA1,oxa,shv,NDM,fox,per genes were not detected.Results showed that 25.7％(18/70),25.7％(18/70) and 12.9％(9/70) strains carried 2,3 and 4 strains resistant genes,respectively.The changes of drug resistance of Escherichia coii were significantly correlated with drug DDDs of ampicillin/sulbactam and ceftazidime (r=0.998 and 0.999,both P＜0.05).Conclusion The detection rate of Escherichia coii producing ESBLs is high in PICU,and the DDDs of some antibiotics are positively correlated with drug resistance,indicating that rational use of antibacterial drugs and strengthening resistance monitoring are important in PICU.关键词
大肠埃希菌/耐药基因/药物使用频度Key words
Escherichia coli/Resistance genes/Defined daily doses引用本文复制引用
吴军华,阮培森,宋启发..PICU产超广谱β-内酰胺酶大肠埃希菌耐药率及其与抗菌药物使用频度相关性分析[J].浙江医学,2017,39(16):1345-1348,1352,5.基金项目
宁波市自然科学基金(2012A610235) （2012A610235）
宁波市自然科学基金(2013A610246) （2013A610246）
