目的 了解內(nèi)蒙古醫(yī)科大學(xué)附屬醫(yī)院尿路感染大腸埃希菌的臨床分布和耐藥性，為臨床泌尿系統(tǒng)抗感染的預(yù)防與治療提供依據(jù)。方法 收集2011—2013年從尿液標(biāo)本中分離的大腸埃希菌968株，對(duì)其臨床分布和耐藥性進(jìn)行回顧性調(diào)查分析。結(jié)果 3年間尿液標(biāo)本中分離大腸埃希菌968株，其中產(chǎn)超光譜β-內(nèi)酰胺酶（ESBLs）菌株508株，ESBLs的檢出率分別為35.7%、48.5%、66.0%，3年平均檢出率為52.6%。大腸埃希菌對(duì)常用抗菌藥物耐藥率最低的是亞胺培南，其次為頭孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星和氨芐西林/舒巴坦，對(duì)其他抗菌藥物的耐藥率較高，3年間平均耐藥率均大于50.0%，而且耐藥率呈逐年上升的趨勢(shì)。分離率居前3位科室依次為腎內(nèi)科、泌尿外科、神經(jīng)內(nèi)科，分別占40.6%、29.1% 和18.0%。結(jié)論 尿液標(biāo)本分離的大腸埃希菌耐藥嚴(yán)重，常規(guī)ESBLs的檢測(cè)有助于合理使用抗菌藥物，降低ESBLs耐藥菌株的產(chǎn)生；臨床醫(yī)師應(yīng)重視藥敏結(jié)果，合理用藥，防止ESBLs菌株的擴(kuò)散。

Objective To investigate the distribution of Escherichia coli from urine specimen and its drugresistance in Affiliated Hospital of Inner Mongolia Medical University, and to provide the reference for the prevention and treatment of urinary infections. Methods The clinical data and drug resistance of 968 strains of E. coli isolated from urine specimens from 2010 to 2013 were reviewed retrospectively. Results The 968 strains of E. coli were isolated from urine samples, there were 508 strains producing ESBLs, and the detection rates of ESBLs accounted for 35.7%, 48.5%, and 66.0%, respectively. The average of detection rates in three years was 52.6%. The drug resistance rate of E. coli to imipenem was the lowest, followed by cefoperazone/sulbactam, piperacillin /tazobactam, amikacin, and ampicillin/sulbactam. E. coli kept high resistance to other antibiotics, and the average resistance rates was higher than 50% in three years and increased year by year. The top three departments of isolation rate were nephrology, urology, and neurology, accounting for 40.6%, 29.1%, and 18.0%, respectively. Conclusion The drug resistance of E. coli from urine samples is serious. Conventional ESBLs test contributes to appropriate the usage of antibiotics and lower the occurrence of drug resistance. Clinicians should pay attention to drug susceptibility results and rational drug usage, which can prevent the spread of ESBLs strains.

內(nèi)蒙古自然科學(xué)基金資助項(xiàng)目（2013MS1163）