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《Chinese Journal of Difficult and Complicated Cases》 2017-03
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Drug resistance and clinical distribution of ESBLs~+ Escherichia coli and Klebsiella pneumoniae strains from culturing blood samples

ZHA Gan;LI Ruiting;WANG Wen;LI Ruiyun;JIN Song;WANG Xun;LI Chunnian;WU Xiaojun;Renmin Hospital of Wuhan University;  
Objective To provide the evidence for treatment of Escherichia coli and Klebsiella pneumoniae infection by investigating its distribution and drug resistance from culturing blood samples.Methods Nine hundred and twenty-one strain of enterobacteriaceae including 487 Escherichia coli and 184 Klebsiella pneumoniae strains isolated from October 2012 to September 2015,all used BACTEC FX BD automatic blood culture system for culturing blood samples,the pathogens identification and resistance test were carried out by automatic microorganism identification instrument(Phoenix 100 BD),and their drug resistance was analyzed by WHONET 5.5 software.Results 2 063 pathogenic strains were detected,921 strains of enterobacteriaceae,including 487 Escherichia coli(52.88%) and 184 pneumonia Klebsiella strains(19.98%),and the detection rate of ESBLs~+ Escherichia coli and pneumonia Klebsiella pneumoniae were 64.48%and 32.61%.The drug resistance of ESBLs~+ Escherichia coli and pneumonia Klebsiella pneumoniae was from 62.1%to 100%to penicillins,cephalosporins,quinolones,and erythromycin and so on.However,the other drug resistance;amikacin(5.2%) and piperacillin/tazobactam(10.3%) have good antibacterial effects;Carbon black enzymes such as meropenem(0.9%) and imipenem(0) were the most sensitive antibacterial drug.The drug resistance rate of ESBLs~+ strain of various antimicrobials(with the exception of Imipenem and meropenem) in blood culture was higher than that of ESBLs,and the difference was statistically significant(P 0.05).Conclusion ESBLs~+ Escherichia coli and pneumoniae in culturing blood for all kinds of antibacterial drugs showed different degrees of resistance,and multi drug resistance,carbapenems including imipenem and meropenem is still the most sensitive anti ESBLs~+ bacteria drug;amikacin and piperacillin/tazobactam also guarantees to good antibacterial effect.Monitoring and drug resistance analysis of ESBLs~+ strains should be strengthened to guide clinical rational drug use,and it is of great significance to control the spread of ESBLs~+ strains and the spread of drug resistance genes.
【Fund】: 湖北省卫生和计划生育委员会项目资助(sj-201209)
【CateGory Index】: R446.5
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