Abstract:

 Objective　To analyze the clinical features and drug resistance of 221 patients with Escherichia coli bloodstream infection at Guangdong Provincial Second Hospital of Traditional Chinese Medicine, and to provide references for the rational use of antimicrobial drugs and the prevention and control of hospital infection in clinical practice. Methods　The data of positive blood culture strains at Guangdong Provincial Second Hospital of Traditional Chinese Medicine from January 2021 to December 2023 were collected. The clinical information and drug sensitivity results of 221 patients with non-duplicative Escherichia coli bloodstream infection were screened, including 95 males (42.99%) and 126 females (57.01%); they were 26-97 years old. According to the production of extended spectyum beta-lactamase (ESBLs), they were divided into an ESBLs group (105 cases) and a non-ESBLs group (116 cases). The resistance rates were compared between the two groups by χ² test. Results　From January 2021 to December 2023, there were 552 cases of positive blood culture in the hospital, including 221 patients with Escherichia coli bloodstream infection. The patients were mainly from the departments of acupuncture (55 cases) and oncology (31 cases). There were 105 ESBLs-producing Escherichia coli strains, accounting for 47.51% of the total strains. Escherichia coli had high resistance rates to levofloxacin (54.30%), cotrimoxazole (50.68%), ceftriaxone (53.39%), and cefuroxime (53.85%), but had high sensitivity to amikacin (3.62%), carbapenems (5.43%), and ertapenem (5.43%). ESBLs-producing Escherichia coli had higher resistance rates to imipenem, ertapenem, ceftazidime, cefepime, ceftriaxone, cefuroxime, and levofloxacin than non-ESBL-producing Escherichia coli (all P<0.05). Conclusions　Escherichia coli bloodstream infection is mainly distributed in the departments of acupuncture and oncology. Most strains produce ESBLs and are resistant to many common antibiotics, but they are highly sensitive to carbapenems, so antimicrobial drugs should be reasonably selected in clinical practice to reduce the generation of drug-resistant bacteria.

Key words:

Bloodstream infection, Escherichia coli, Clinical features, Antimicrobial resistance analysis

摘要：

目的　分析广东省第二中医院221例大肠埃希菌血流感染患者的临床特征和耐药情况，为临床针对其感染合理使用抗菌药物和院感防控提供参考。方法　收集广东省第二中医院2021年1月至2023年12月血培养阳性菌株数据，筛选出221例非重复大肠埃希菌血流感染患者的临床信息及药敏结果，其中男95例（42.99%），女126例（57.01%），年龄26～97岁。根据是否产超广谱β-内酰胺酶（extended spectrum beta-lactamase，ESBLs）分为产ESBLs组（105例）和非产ESBLs组（116例）。采用χ²检验比较两组大肠埃希菌耐药率。结果　2021年1月至2023年12月，院内血培养阳性552例，其中大肠埃希菌血流感染患者221例。患者主要来自针康科（55例）和肿瘤科（31例）。产ESBLs大肠埃希菌共105株，占总数的47.51%。大肠埃希菌对左氧氟沙星（54.30%）、复方新诺明（50.68%）、头孢曲松（53.39%）和头孢呋辛（53.85%）的耐药率较高，但对阿米卡星（3.62%）和亚胺培南（5.43%）、厄他培南（5.43%）2种碳青霉烯类药物具有较高的敏感性。产ESBLs大肠埃希菌对亚胺培南、厄他培南、头孢他啶、头孢吡肟、头孢曲松、头孢呋辛和左氧氟沙星的耐药率比非产ESBLs大肠埃希菌的高（均P<0.05）。结论　广东省第二中医院大肠埃希菌血流感染主要分布在针康科和肿瘤科。大部分菌株产ESBLs，对多种常见抗生素耐药，但是对碳青霉烯类药物的敏感性较高，临床应合理选择抗菌药物，减少耐药菌的产生。

关键词:

血流感染, 大肠埃希菌, 临床特征, 耐药分析