沙雷菌属在医院的分布及药敏结果分析

Antimicrobial Susceptibility and Distribution of Serratia in Hospital:Analysis of Result

目的研究沙雷菌属的分布情况,了解褪色沙雷菌对抗菌药物的体外敏感性,为临床合理用药提供参考。方法对医院2001-2006年临床分离的222株沙雷菌属的临床分布和164株褪色沙雷菌药敏情况进行统计分析,细菌鉴定和药敏均应用法国生物梅里埃公司的VITEK-2,数据分析应用WHONET5.4软件。结果沙雷菌属主要来源于痰、尿、血液、分泌物、胆汁、脑脊液、腹水等标本,住院及门诊患者均可发生沙雷菌属感染,以外科病房(125株)为主;褪色沙雷菌对哌拉西林、头孢唑林、头孢呋辛、庆大霉素和妥布霉素的耐药率较高,均>60%,全部对亚胺培南敏感,MIC90仅为1μg/ml,对哌拉西林/他唑巴坦、头孢他啶、头孢吡肟、左氧氟沙星敏感率均>80%。结论沙雷菌属在临床的分离较少,其对一代、二代头孢菌素表现很高的耐药性,对三代头孢菌素也表现不同程度的耐药,临床医生应重视其引起的感染。

OBJECTIVE To study clinical distribution of Serratia and learn the antimicrobial susceptibility to S. rnarcescens in vitro in order to offer the reference to optimally selecting antibiotic. METHODS It was analyzed that the 222 Serratia strains were distributed in and the was deteted 164 S. marcescens strains were isolated from our hospital from 2001 to 2006. Their VITEK-2 of French Bio-Merieux Company was adopted to proceed the identification of bacteria and antimicrobial susceptibility test. Data were analyzed by WHONET 5. 4. RESULTS Serratia were mainly isolated from sputum, urine, blood, secretion, bile, cerebrospinal fluid, abdominal fluid, etal. Infection of both in-and out-patients could be caused by Serratia and most were in surgery ward. S. rnarcescens had higher drug resistance rates to piperacillin, cefazolin, cefuroxime, gentamicin and tobramycin which were all above 60%. They were all susceptible to imipenem （minlmum inhibitory concentration only 1 μg/ml） and their susceptible rates to plperacillin/tazobactam, ceftazidime, cefepime, and levofloxacin were all higher than 80%. CONCLUSIONS Serratia are less isolated from clinics, but have much higher antimicroblal resistance to the 1st and 2nd generation cephalosporin and show diversely drug resistance to 3rd cephalosporin, so physicians should pay attention to the infection caused by them.