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目的分析近两年来深圳市第三人民医院产超广谱β-内酰胺酶(ESBLs)-大肠埃希菌(ECO)的来源标本类型、病区分布,以及危险因素,为医院感控和临床抗感染治疗提供细菌学依据。方法收集该院住院患者检出的非重复ECO 443株,采用phoenix100系统进行菌种鉴定和药敏实验,并对产ESBLs-ECO进行双纸片协同试验确证,对产ESBLs-ECO感染的危险因素进行统计分析。结果 443株ECO中产ESBLs-ECO为115株,占26.0%;产ESBLs-ECO菌株主要分离自痰液、尿液和血液标本,病区分布以结核病区、儿科、肝病区和感染科为主,分别占20.9%、13.9%、12.2%和8.7%。男性、外科手术和第三代头孢菌素用药史是产ESBLs-ECO感染的独立危险因素。结论该院产ESBLs-ECO检出率较高,医院应根据危险因素制订干预措施,特别应重点关注男性患者,规范外科手术操作及消毒,限制使用第三代头孢菌素,减少院内产ESBLs-ECO的发生和传播。
Objective To analyze the types, ward distribution and risk factors of ESBLs-producing Escherichia coli (ECO) in the Third People’s Hospital of Shenzhen in the past two years for the purpose of hospital control and clinical Anti-infective therapy provides a bacteriological basis. Methods Non-repetitive ECO 443 strains were collected from hospitalized patients in this hospital. Phoenix100 system was used for identification of bacteria and drug susceptibility test. Syndrome-producing ESBLs-ECO was confirmed by double paper synergy test. The risk factors for ESBLs-ECO infection conduct statistical analysis. Results Among the 443 ECO isolates, 115 were ESBLs-ECO strains, accounting for 26.0%. ESBLs-producing strains were mainly isolated from sputum, urine and blood samples. The distribution of TB was mainly from tuberculosis, pediatrics, liver disease and infectious diseases. Accounting for 20.9%, 13.9%, 12.2% and 8.7% respectively. Male, surgical and third-generation cephalosporin medication history is an independent risk factor for ESBLs-ECO infection. Conclusions The detection rate of ESBLs-ECO in this hospital is high. The hospital should make interventions according to risk factors. In particular, it should focus on male patients, regulate the operation and disinfection of the patients, restrict the use of the third generation cephalosporins, reduce the incidence of ESBLs- The occurrence and spread of ECO.