Risk factors associated with cefepime-resistant Escherichia coli isolates in sterile body fluid

孙继德; 付双双; 黄世峰; 徐绣宇; 张莉萍

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Risk factors associated with cefepime-resistant Escherichia coli isolates in sterile body fluid

更新时间：2026-01-09

- Risk factors associated with cefepime-resistant Escherichia coli isolates in sterile body fluid
- Journal of Army Medical University Vol. 36, Issue 19, Pages: 2030-2033(2014)
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  CLC： R378.2;R915;R978.11
- Published：2014
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孙继德,付双双,黄世峰,徐绣宇,张莉萍.无菌体液中大肠埃希菌对头孢吡肟耐药的危险因素分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(19):2030-2033.

　Sun Jide,Fu Shuangshuang,Huang Shifeng,Xu Xiuyu,Zhang Liping.Risk factors associated with cefepime-resistant Escherichia coli isolates in sterile body fluid[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(19):2030-2033.
孙继德,付双双,黄世峰,徐绣宇,张莉萍.无菌体液中大肠埃希菌对头孢吡肟耐药的危险因素分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(19):2030-2033. DOI：

　Sun Jide,Fu Shuangshuang,Huang Shifeng,Xu Xiuyu,Zhang Liping.Risk factors associated with cefepime-resistant Escherichia coli isolates in sterile body fluid[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(19):2030-2033. DOI：

摘要

目的探讨无菌体液中大肠埃希菌对头孢吡肟耐药的危险因素。方法收集2012年7月至2013年8月间医院在无菌体液中分离的288株大肠埃希菌，对患者病例做回顾性病例对照分析。病例组为96株头孢吡肟耐药菌株，对照组为192株头孢吡肟敏感菌株。Logistic回归模型被用来分析大肠埃希菌对头孢吡肟耐药的独立危险因素。结果大肠埃希菌对头孢吡肟的耐药率为33.3%。产超广谱β-内酰胺酶（ESBLs）、先前使用抗生素（尤其是头孢菌素）、男性、先前住院天数≥10 d、机械通气、引流管、导尿管和静脉置管等是大肠埃希菌对头孢吡肟耐药的主要危险因素。其中，产ESBLs、先前使用抗生素、先前住院天数≥10 d和男性是其独立危险因素。结论有上述危险因素存在的患者，尤其是男性，应尽量缩短住院时间，减少侵入性操作，慎用头孢菌素类药物，以减少头孢吡肟耐药菌株的出现。

Abstract

Objective To identify the risk factors for acquisition of cefepime (FEP) resistance among Escherichia coli (E. coli) isolates in sterile body fluid. Methods A total of 288 successive and non-duplicate E. coli strains isolated from sterile body fluid specimens during July 2012 to August 2013 in our department were recruited for case-control study. Ninety-six case was defined as FEP-resistant isolates while 192 cases with FEP-susceptive isolates served as control. Logistic regression was performed to evaluate the independent risk factors. Results Out of the 288 total isolates

33.3% (96/288) were resistant to FEP. Production of extended spectrum beta-lactamases (ESBLs)

previous antibiotic use

≥10 d of hospital stay before infection and male were the independent risk factors associated with FEP-resistant E. coli isolates. Other major risk factors included previous use of cephalosporins

mechanical ventilation

drainage tube

urinary or intravenous catheterization. Conclusion Patients (especially male) with above-mentioned risk factors should be kept to a shorter hospital stay

less invasive operations and more cautious use of cephalosporins in order to control the emergence of cefepime-resistant strains.

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