| Objective To explore the drug resistance rate of clinical ESBLs-producing Escherichiacoli to 7 commonly used antibiotics,such as piperacillin,tazobactam?TZP?,aztreonam?AZT?and Amikacin?AMK?,as well as the collateral sensitivity and collateral resistance to 10 different antibiotics which commonly used in clinical,and to reveal the drug resistance regularity of clinical ESBLs-producing Escherichia coli.Finally,the distribution and drug sensitivity of the main gram negative bacteria in Yichun People's Hospital were analyzed,so as to provide reference for the rational and effective use of antibiotics and treatment regimens forclinical ESBLs-resistant Escherichia coli.Methods Using gradient plate method to induce the clinical production of ESBLs-Escherichia coli to 10 kinds of antibiotics,such as piperacillin,tazobactam,aztreonam and so on,and induce them to the direction of the highest concentration of human drug distribution.At the same time,the MIC value of clinical ESBLs-producing Escherichia coli before and after induction of drug resistance was detected by micro broth dilution method.The changes of MIC value and the identification of the strains before and after the induction of the strain were compared.Finally,the collateral sensitivity and drug resistance spectrum were plotted with HemI software.Collect the electronic medical records of Yichun People's Hospital in 2018 and the third quarter of 2019,and analyze the distribution and drug sensitivity of ESBL-Escherichia coli and the main gram negative bacteria.Results The results showed that the drug resistance rate of levofloxacin,Amikacin,furonidin,aztreonam,meropenem and imipenem were accelerated after second,third,fifth,2,25 and 30 cycles respectively,and the drug resistance of levofloxacin,Amikacin and furondine was close to the highest concentration of human drug after fourth,seventh,tenth induction cycles.After more than 20 induction cycles,the resistance level of aztreonam did not reach the highest concentration of drug distribution in the human body.Meropenem was more than the highest plasma concentration(about 100 mg·L-1)after 35 induction cycles(the highest concentration was 60 mg·L-1).The resistance rate of piperacillin and tazobactam was generally mild after first to 17 cycles.The level of drug resistance gradually reached the highest blood concentration in the human body.The results of side branch sensitivity and drug resistance showed that with the continuous progression of drug resistance,the collateral sensitivity or collateral drug resistance of clinical ESBLs-producing Escherichia coli to other antibiotics remained unchanged.However,a small number of patients will show resistance to antibiotics or be sensitive to drug resistance.The use of piperacillin,tazobactam and Amikacin replacement may effectively eradicate the clinical production of ESBLs-producing Escherichia coli.Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii and Pseudomonas aeruginosa are very different in the frequencyof resistance to levofloxacin,aztreonam,furantoin,piperacillin,tazobactam,Amikacin,and imipenem,respectively.However,the antibiotic resistance rates of Escherichia coli and ESBL-producing Escherichia coli were basically the same:the order of resistance rates of levofloxacin,aztreonam,furanto,piperacillin,tazobactam,Amikacin and imipenem decreased.Conclusion ESBLs-producing Escherichia colito aztreonam,amikacin and levofloxacin are easily resistant.clinical ESBLs-producing Escherichia colito piperacillin,tazobactam,carbofuran,meropenem and imipenem are less resistant.Cerollatal Sensitivity and Collateral Resistance of clinical ESBLs-producing Escherichia coli on antimicrobial agents can provide theoretical basis and experimental support for the determination of clinical antibacterial drug selection plan. |
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