Ma Yue, Li Jing-yun, Yao Lei, Zhang Li, Hu Chang-qin, Jin Shao-hong
National Institute for the Control of Pharmaceutical and Biological Products, National Center for Surveillance of Antimicrobial Resistance, Beijing 100050, China.
Zhonghua Yi Xue Za Zhi. 2003 Jun 25;83(12):1046-8.
To investigate the antimicrobial resistance of Escherichia coli (E. coli) isolates collected from the inpatients in the departments of medicine, surgery, and pediatrics, and intensive care unit (ICU), and from the outpatients.
Disc diffusion test was used to study the antimicrobial resistance of 3909 strains of E. coli collected from the inpatients in the departments of medicine, surgery, and pediatrics, and Intensive care unit (ICU), and from the outpatients, mostly isolated from urine, sputum, blood, and different secreta in the year 2001. WHONET 5 software was used for analysis of the antimicrobial resistance; and significant differences were tested by chi(2) to compare the resistance rates to antibiotics.
The incidences of extended-spectrum beta-lactamases producing strains were 11.2% (195/1737), 14.3% (141/983), 17.7% (28/158), 19.7% (24/122) and 8.4% (76/909) in the strains of E. coli isolated from the inpatients in the departments of medicine, surgery, and pediatrics, and ICU and from the outpatients respectively, with a detectable rate among the outpatients significantly lower than that among the inpatients (P < 0.005), and a detectable rate among the inpatients in the department of medicine significantly lower than those among the inpatients in the department of pediatrics and ICU (both P < 0.05). The resistance rates to cefazolin, cefotaxime, gentamicin and aztreonam of the isolates from the outpatients were significantly lower than those of the inpatients (all P < 0.05). The resistance rates to amoxicillin/clavulanic acid, ceftazidime, cefepime and amikacin of the isolates from the outpatients were significantly lower than those of the inpatients in the department of surgery and ICU (all P < 0.05); The resistance rates to ciprofloxacin and trimethoprim/sulfamethoxazole of the isolates from the outpatients were significantly lower than those from the ICU patients (both P < 0.05). The resistance rates to cefazolin and cefotaxime of E. coli isolates collected from the inpatients in the department of medicine were significantly lower than those of the isolates from the department of surgery and ICU (all P < 0.01); the resistance rates to gentamicin of the isolates from the department was significantly lower than that of the isolates from the department of surgery (P < 0.05). The resistance rates to amoxicillin/clavulanic acid and aztreonam of the isolates from the department of medicine were significantly lower than those of the isolates from the ICU (both P < 0.05). The resistance rate to ciprofloxacin of isolates from the inpatients in the department of pediatrics was significantly lower than that of the other isolates (all P < 0.01).
It is of guiding significance for empirical use of antimicrobial agents in clinic to study on the resistant rates of the strains of E. coli isolated from different departments in hospital.
调查从内科、外科、儿科住院患者、重症监护病房(ICU)患者及门诊患者中分离出的大肠埃希菌(大肠杆菌)的耐药性。
采用纸片扩散法研究2001年从内科、外科、儿科住院患者、重症监护病房(ICU)患者及门诊患者中分离出的3909株大肠杆菌的耐药性,这些菌株大多分离自尿液、痰液、血液及不同分泌物。使用WHONET 5软件分析耐药性;采用卡方检验比较抗生素耐药率的差异。
从内科、外科、儿科住院患者、ICU患者及门诊患者中分离出的大肠杆菌菌株中产超广谱β-内酰胺酶菌株的发生率分别为11.2%(195/1737)、14.3%(141/983)、17.7%(28/158)、19.7%(24/122)和8.4%(76/909),门诊患者中的检出率显著低于住院患者(P<0.005),内科住院患者中的检出率显著低于儿科和ICU住院患者(均P<0.05)。门诊患者分离株对头孢唑林、头孢噻肟、庆大霉素和氨曲南的耐药率显著低于住院患者(均P<0.05)。门诊患者分离株对阿莫西林/克拉维酸、头孢他啶、头孢吡肟和阿米卡星的耐药率显著低于外科和ICU住院患者(均P<0.05);门诊患者分离株对环丙沙星和复方磺胺甲恶唑的耐药率显著低于ICU患者(均P<0.05)。从内科住院患者中分离出的大肠杆菌对头孢唑林和头孢噻肟的耐药率显著低于外科和ICU分离株(均P<0.01);该科室分离株对庆大霉素的耐药率显著低于外科分离株(P<0.05)。内科分离株对阿莫西林/克拉维酸和氨曲南的耐药率显著低于ICU分离株(均P<0.05)。儿科住院患者分离株对环丙沙星的耐药率显著低于其他分离株(均P<0.01)。
研究医院不同科室分离的大肠杆菌菌株的耐药率对临床抗菌药物的经验性使用具有指导意义。