外科手术切口感染大肠埃希菌的耐药性分析

目的分析外科手术切口中大肠埃希菌的感染率及耐药性,为临床合理用药提供科学依据。方法对2009年6月至2010年9月外科患者手术切口标本中分离的大肠埃希菌耐药情况进行分析,并对产超广谱β-内酰胺酶（ESBLs）菌株进行表型确证试验。结果 140株大肠埃希菌中,产ESBLs菌株的检出率为42.14%;产ESBLs菌株对一～四代头孢菌素、广谱青霉素、氟哇诺酮类及氨基糖苷类抗菌药物具有较高的耐药率;非产ESBLs菌株对青霉素类以外的抗菌药物具有较高的敏感率;产ESBLs菌株对大多数抗菌药物的耐药率明显高于非产ESBLs菌株（P〈0.05）。结论外科手术切口术后大肠埃希菌的感染较严重,且产ESBLs菌株多药耐药明显,临床应加强监测与控制。

Drug resistance analysis of Escherichia coli causing surgical incision infection

Objective To explore the detection ratio and drug resistance of Escherichia coli in surgical incision infection for clinical rational medication.Method The drug resistance of Escherichia coli in surgical incision infection from June 2009 to October 2010 was analyzed and the isolated strains producing extended spectrum β-lactamase(ESBLs) were identified using Phenotypic Confirmatory Test.Result The detection rate of ESBLs producing Escherichia coli strains were 42.14% among the 140 isolated strains,which had high drug resistance ratio to the first to fourth-generation of cephalosporin,penbritin,Quinolone and aminoglycosides.Non ESBLs-producing E.coli had a high sensitivity to most of the antibiotics except penicillins.The drug resistance ratio of ESBLs producing E.coli was higher than that of non ESBLs producing E.coli significantly(P<0.05).Conclusion The ESBLs producing E.coli has a high detection ratio in surgical incision with a high drug resistance.It is necessary to further monitor and control the production and spread of the drug resistant bacterium.