1300株临床分离需氧革兰阴性杆菌耐药性分析

Analysis of antimicrobial resistance of 1 300 strains of aerobic gram- negative bacilli isolated from clinical specimens

目的 了解某院临床分离的需氧革兰阴性杆菌耐药状况,为临床合理使用抗菌药物提供参考。方法对2 0 0 1年7月1日～2 0 0 3年9月30日临床分离的需氧革兰阴性杆菌进行药物敏感试验及耐药性分析。结果 130 0株需氧革兰阴性杆菌中,常见的临床分离菌依次为大肠埃希菌(40 5株,31.15 % )、铜绿假单胞菌(2 15株,16 .5 4 % )、肺炎克雷伯菌(2 14株,16 .4 6 % )、鲍曼不动杆菌(16 1株,12 .38% )和肠杆菌属(112株,8.6 2 % )。在观察的16种抗菌药物中,细菌对亚胺培南的耐药率最低,为4 .77% ,其次为头孢他啶(2 0 .6 2 % )、阿米卡星(2 2 .77% )、头孢替坦(2 9.2 3% )和替卡西林/棒酸(2 9.15 % ) ;对氨苄西林、氨苄西林/舒巴坦及一代头孢、复方甲基异唑的耐药性较高。大肠埃希菌产超广谱β内酰胺酶(ESBLs)株检出率为2 2 .98% ,肺炎克雷伯菌产ESBLs株检出率为2 7.5 7%。结论 细菌的耐药性较为严重,应根据细菌的药敏情况选用合适的抗菌药物进行治疗以减少细菌抗药性的产生。

Objective To investigate antimicrobial resistance of aerobic gram-negative bacilli isolated from clinical specimens and provide guidance of rational use of antimicrobial agents for clinic. Methods 1 300 strains of aerobic gram-negative bacilli isolated from clinical specimens from July 1,2001 to September 30,2003 were performed antimicrobial susceptibility tests. Results The commonly isolated bacteria were: Escherichia coli (405 strains, 31.15%), Pseudomonas aeruginosa (215 strains, 16.54%), Klebsiella pneumonia (214 strains, 16.46%), Acinetobacter baumannii (161 strains, 12.38%) and Enterobacter (112 strains, 8.62%). Imipenem had the lowest antimicrobial susceptibility rate ( 4.77%), followed by ceftazidime ( 20.62%), amikacin ( 22.77%), cefotetan ( 29.23%) and ticarcillin/clavulanic acid ( 29.15%), the resistant rates to ampicillin, ampicillin/sulbactam, the first generation cephalosporins and SMZco were high. Extended spectrum β-lactamase-producing rate of Escherichia coli and Klebsiella pneumonia was 22.98% and 27.57% respectively. Conclusion The resistance of bacteria to antimicrobial agents is a serious problem. Choice of antimicrobial agents should be based on the antimicrobial susceptibility test so as to reduce the occurrence of antimicrobial resistance.