目的 了解内蒙古医科大学附属医院尿路感染大肠埃希菌的临床分布和耐药性，为临床泌尿系统抗感染的预防与治疗提供依据。方法 收集2011—2013年从尿液标本中分离的大肠埃希菌968株，对其临床分布和耐药性进行回顾性调查分析。结果 3年间尿液标本中分离大肠埃希菌968株，其中产超光谱β-内酰胺酶（ESBLs）菌株508株，ESBLs的检出率分别为35.7%、48.5%、66.0%，3年平均检出率为52.6%。大肠埃希菌对常用抗菌药物耐药率最低的是亚胺培南，其次为头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星和氨苄西林/舒巴坦，对其他抗菌药物的耐药率较高，3年间平均耐药率均大于50.0%，而且耐药率呈逐年上升的趋势。分离率居前3位科室依次为肾内科、泌尿外科、神经内科，分别占40.6%、29.1% 和18.0%。结论 尿液标本分离的大肠埃希菌耐药严重，常规ESBLs的检测有助于合理使用抗菌药物，降低ESBLs耐药菌株的产生；临床医师应重视药敏结果，合理用药，防止ESBLs菌株的扩散。

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.

内蒙古自然科学基金资助项目（2013MS1163）