Infection Status And Resistance Analysis Of ESBLs Escherichia Coli

The antibiotic is one of the greatest achievements in the medical field, However, the question that the domestic and international antibiotic abused is very outstanding at present, which results being able to bear the medicine resistant bacteria to increase sharply. extended spectrumβlactamase (ESBLs) is one of the most important pathogenic bacterium in the hospital. In recent decades, with constant increase of the antibiotic medicine kind and extensive application, the serious infection that ESBLs causes runs up in the world. Bacteria producingβ-Lactamases is the main mechanism ofβ-lactam antibiotics drug resistance, while plasmid-mediated extended- spectrumβ-lactamases (ESBLs) is the main reason of new generationβ-lactam antibiotics drug resistance. ESBLs not only can hydrolyze Penicllin and cephalosporin, but also can hydrolyze the third,fourth generation of cephalosporins and plasmid-mediated (BLA) of antibiotic, It's hydrolysis activity can be inhibited by BLA inhibitor, but cephalomycin and Carbapenems is more effective.β-Lactamases -mediated drug resistance developed rapidly,whenever a new kind ofβ-lactam antibiotics was used by clinic, a newβ-Lactamase which can hydrolyze it was produced in no long time. What's more, ESBLs is multidrug resistant not only for methicillin but also forβ- lactam antibiotics, aminoglycosides, macrolides and so on. IPM and MEM were the most active antibiotics tested against ESBLs-Ecoli.In order to understand the current situation that hospital onset of infection caused by ESBLs in the first hospital of Jilin University, while to benefit clinical to select antibiotic for use rationally, and at the same time preventing to break out, the research was done to detect ESBLs in 501samples from patients in clinic and in hospital which was infected by staphylococcus aureus from January 2006 to December 2007 by cefoxitin disc diffusion method ,oxacillin disc diffusion method and mecA Genes PCR method .The results shows that the total isolating rate is 53.8%by the three methods. Among them, the isolating rate in 2006 is 50.6% (118/233), and the isolating rate in 2007 is 56.7% (152/268). The tendency is to rise year by year. Sputum, pus and drain take the most part of the sample in ESBLs infection, constituent ratios are 40.1%, 28.8% and 10.2%. It is clear that the respiratory tract is the major part in ESBLs infection; while the infection divisions are the neurosurgery, ICU, and the general surgery, which take 54.6% in all. The available data were analyzed by Chi-square test and multiple Logistic regression model. The Chi-square test showed that the risk factors of ESBLs infection were long-term hospitalization, invasive operation, using antibiotics, complicated infection and hospitalization in neurosurgery. The multivariable conditional Logistic regression analysis showed that the invasive operation, the antibiotic use and the neurosurgery are related to ESBLs The agar dilution on susceptibility test of 16 antibiotics shows that ESBLs is drug fast withβ-lactam antibiotics, the multidrug resistant is serious in ESBLs, the drug fast rate exceed 75% for LEV, CIP, CXM, CRO, PRL and CTX. The positive rate of ESBLs-producing Escherichia coli is its genotype by CTX-M-type primarily, further more it's drug- resistant rate is significant higher than non-ESBLs-producing Escherichia coli.Bacterium facing the strong choice pressure because of the generally and irrationality use of antibiotic, drug resistant strain accommodates the new selection pressure and exist, while non-drug fast sensitive strain is rejected, so drug resistant strain become more and more. And this makes difficulties for clinic. So, antibiotic should be used as follows: Select proper antibiotic by measuring and medicine quick result of the test according to bacterium, while choose the right antibiotic according to local prevailing state of pathogen condition if there is no suitable condition, and select the antibiotic which is low-grade, low price and good function as much as possible; following the cooperation principal while use the antibiotic; and do not change the antibiotic frequently if there is no clear out indication. This finding has significant guidance for establishing the monitoring of the drug fast and antibiotic rational use and controlling multidrug resistant.