医院感染的革兰阴性杆菌的耐药变迁

Transition of drug resistance of Gram-negative bacilli in nosocomial infection

目的了解本院医院感染的肠杆菌科细菌和非发酵菌的感染情况及对常用药物的耐药性,指导临床合理使用抗生素。方法参照《全国临床检验操作规程》,对医院微生物室近3年检出阳性标本进行分析、统计。结果肠杆菌科细菌576株,非发酵菌属474株,肠杆菌科细菌中大肠埃希菌、产气肠杆菌、泉居沙雷菌,戴氏西地西菌对先锋必、氧哌嗪耐药率达83.33%以上,泉居沙雷菌对丁胺卡那的耐药率为66.67%,而大肠埃希菌、产气肠杆菌、戴氏西地西菌对丁胺卡那的耐药率则在16.67%以下,非发酵菌属中短黄杆菌、嗜麦芽窄食单胞菌、铜绿假单胞菌对头孢噻肟的耐药率均达100%,对先锋必、氧哌嗪耐药率也很高,为80%以上,而对丁胺卡那的耐药率为27.27%以下。结论在常用药物中,丁胺卡那对肠道杆菌和非发酵菌的作用很强,而先锋必、氧哌嗪作用较弱。

Objective To investigate the transition of drug resistance in the part of the bacteria causing nosocomial infection in our hospital and to direct using antibiotics reasonably. Methods Referring to Rules of Operation in Clincal Laboratory of Nationwide,the positive samples of nosoeomial infection were analyzed statistically. Results There were 576 isolates of enterobacteriaeeae, 474 isolates of nonfermenters. In Eseherchia eoli, enterobacter aerogenes,serratia fonticola and eikenella corrodens of enterobacteriaceae,resistance rate to cefoprazone and piperacillin was over 83. 33%, but, to anikaein was below 66. 67%. In Flavobacterium, Stenotrophomonas maltophilia. Pseudmonas aeruginosa of nonfermenters, resistance rate to cefotaxime reached 100%, to cefoprazone and piperacillin reached over 80% ,but to amikacin,it was below 27.27%. Conclusion Anikaein in common drugs has powerful function to enterobacteriaceae and nonfermenters in vitro.