855株革兰阴性分离杆菌分布及耐药性分析

    Distribution and drug resistance of 855 isolated gram-negative bacilli

    • 摘要: 目的:了解临床分离的常见G-杆菌的分布及耐药状况,为临床合理使用抗生素提供依据。方法:将2007~2009年各类临床标本按照全国临床检验操作规程进行分离培养,采用Micro Scan-40S型半自动微生物鉴定仪和药敏系统进行鉴定和药敏试验,部分菌株用K-B法,结果按照临床实验室信息系统(Clinical Laboratory Information Systems,CLIS)标准判断。结果:分离出G-杆菌855株,其中大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌居前3位;大肠埃希菌和肺炎克雷伯菌产β内酰胺酶检出率为58.6%和29.7%;非发酵菌以铜绿假单胞菌、鲍曼不动杆菌和嗜麦芽寡养单胞菌为主。大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌对亚胺培南的敏感率均>90.0%;铜绿假单胞菌对亚胺培南和阿米卡星的敏感率为62.4%,对头孢吡肟的敏感率为43.5%;鲍曼不动杆菌对亚胺培南、阿米卡星和罗米沙星的敏感率分别为92.7%、63.4%和60.2%;嗜麦芽寡养单胞菌对复方磺胺甲口恶唑的敏感率为100.0%。结论:临床应及时与微生物实验室联系,关注多重耐药细菌的出现,并根据药物敏感性试验结果个体化、合理应用抗生素,以提高感染治疗成功率,有效减少耐药菌株。

       

      Abstract: Objective: To monitor the distribution and drug resistance of clinically isolated common gram-negative bacilli so as to provide basis for appropriate use of antibiotics in clinic.Methods: The bacillus samples collected in the period of 2007 to 2009 were isolated and cultured according to the National Clinical Laboratory Procedures.The identification and drug susceptibility tests were carried out by using Micro Scan-40S semi-automatic microbiological assay and drug susceptibility system,and part of the strains was detected by K-B method.The results were evaluated in accordance with the standard of Clinical Laboratory Information Systems.Results: Eight hundred and fifty-five gram-negative bacilli were isolated.Escherichia coli,Pseudomonas aeruginosa and Acinetobacter baumann occupied the top three places.The detection rates of Escherichia coli and Klebsieua pneumoniae producing extended spectrum β lactamases were 58.6% and 29.7%,respectively;non-fermenting bacteria mainly consisted of Pseudomona aeruginosa,Acinetobacter Baumannii and Strenotrophomonas maltophilia;the sensitive rate of Escherichia coli,Klebsieua pneumoniae and Entrobacter to imipenem were all above 90.0%;the sensitive rate of Pseudomona aeruginosa to imipenem and amikacin was 62.4%,and to cefepime 43.5%;the sensitive rates of Acinetobacter Baumannii to imipenem,amikacin and luomefloxacia were 92.7%,63.4% and 60.2%,respectively;and the sensitive rate of Strenotrophomonas maltophilia to sulfamethoxazole was 100.0%.Conclusions: Clinicians should keep contact with the microbiology laboratory,be alert of the appearance of multi-resistant bacteria and use antibiotics individually and reasonably according to the drug sensitivity results so that the treatment effect could be improved and the emergence of resistant strains reduced.

       

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