大肠埃希菌泌尿系统感染患者临床分布及药物敏感性分析

摘要 目的：探讨大肠埃希菌引起泌尿系统感染患者的临床分布情况及其药物敏感性分析，为临床诊断及合理使用抗菌药物提供理论性依据。方法：选取2015年1月至2020年12月期间诊治的2052例大肠埃希菌泌尿系统感染患者为研究对象，使用MALDI-TOF MS全自动微生物鉴定质谱仪对细菌进行鉴定，应用VITEK 2 Compact全自动微生物鉴定及药敏分析仪进行药物敏感性分析。结果：2052例大肠埃希菌泌尿系统感染患者中泌尿外科患者占比最高，为17.50%，其次为肾病科患者，占12.87%。其中检出803株产ESBLs的大肠埃希菌，泌尿外科占比最高，为18.56%，其次是肾病科占13.95%，内分泌科占11.71%，重症医学科10.09%。2052株大肠埃希菌整体药敏分析结果显示，大肠埃希菌对美罗培南、亚胺培南、阿米卡星、哌拉西林/他唑巴坦、呋喃妥因、米诺环素、头孢西丁等药物敏感率高，均>90%，头孢唑啉、环丙沙星、左氧氟沙星、氨苄西林/舒巴坦、复方新诺明、氨苄西林敏感率低，均<50%，其中氨苄西林敏感率最低，只有28.17%。结论：大肠埃希菌泌尿系统感染主要发生在泌尿外科，产ESBLs大肠埃希菌整体检出率较高，临床应重视泌尿系统感染患者的尿细菌培养及药物敏感性分析，尽量避免仅凭经验性用药，根据药物敏感性结果合理选择抗菌药物。

Analysis of Clinical Distribution and Drug Sensitivity of Patients with Urinary System Infection of Escherichia Coli

ABSTRACT Objective: To investigate the clinical distribution and drug sensitivity of patients with urinary tract infection caused by escherichia coli, and to provide theoretical basis for clinical diagnosis and rational use of antibiotics. Methods: 2052 patients with urinary tract infection caused by escherichia coli from January 2015 to December 2020 were selected as the research objects. The bacteria were identified by MALDI-TOF MS automatic microbial identification mass spectrometer, and the drug sensitivity was analyzed by VITEK 2 Compact automatic microbial identification and drug sensitivity analyzer. Results: Among 2052 cases of Escherichia coli urinary system infection patients, urology patients accounted for the highest proportion at 17.50%, followed by nephrology patients at 12.87%.Among them, 803 strains of ESBLs-producing escherichia coli were detected, and the urology department accounted for the highest proportion at 18.56%, followed by the nephrology department with 13.95%, the endocrinology department with 11.71%, and the Intensive care unit with 10.09%. The results of the overall drug sensitivity analysis of 2052 strains of escherichia coli showed that the sensitivity rates of escherichia coli to meropenem, imipenem, amikacin, piperacillin/tazobactam, nitrofurantoin, minocycline and cefoxitin were high, all >90%, and the sensitivity rate of cefazolin, ciprofloxacin, levofloxacin, ampicillin/sulbactam, compound trimethoprim and ampicillin were low, all <50%, while the ampicillin was the lowest, only 28.17%. Conclusion: Urinary tract infection of escherichia coli mainly occurs in urology department. The overall detection rate of ESBLs-producing escherichia coli is high. Clinical attention should be paid to the urinary bacterial culture and drug sensitivity analysis of patients with urinary tract infection, try to avoid only empirical medication, and reasonably choose antibiotics according to the results of drug sensitivity.