长春市老年人下呼吸道感染常见革兰阴性杆菌耐药监测

Drug resistance surveillance of common gram-negative bacteria of lower respiratory tract of elderly patients in Changchun

目的:了解长春市老年人下呼吸道感染常见革兰阴性杆菌(G-杆菌)的耐药情况。方法:采用VITEK-2全自动细菌鉴定仪进行细菌鉴定;药物敏感试验使用K-B法;采用WHONET软件对耐药数据进行分析。结果:共分离G-杆菌910株,以铜绿假单胞菌210株(23%)占首位,大肠埃希菌190株(21%)次之,克雷伯菌170株(19%),鲍曼不动杆菌100株(11%),其他阴性杆菌240株(26%)。所有阴性杆菌对抗菌药物的耐药率由低至高依次为亚胺培南5.6%;美罗培南6.6%;头孢派酮/舒巴坦12.9%;派拉西林/三唑巴坦17.2%;头孢比肟19.8%,其中铜绿假单胞菌对氨苄西林/舒巴坦耐药高达100%;所有阴性杆菌对三代头孢的耐药率高达50%以上。结论:长春市老年患者下呼吸道感染常见G-杆菌多重耐药非常严重,因此应定期监测该市革兰阴性杆菌的耐药趋势,对指导临床合理使用抗生素是非常必要的。

Objective： To investigate the resistance of G-bacteria from lower respiratory tract in elderly.Methods：Identification of bacteria performed by VITEK-2.Antimicrobial susceptibility of the clinical isolates collected was tested by Kirby-Baue method.The results were analyzed according to NCCLS by WHONET 5 software.Results：A total of 910 strains of G-bacteria were isolated,which were Pseudomonas aeruginosa 210（23%）,E.coli 190（21%）,Klebsiella 170（19%）,and Acinetobacter 100（11%） in sequence.The resistant rates to antibiotics from high to low level were Imipenem 5.6%,Meraopenem 6.6%,Cef operazone/Sulbactam 12.9%,Piperacillin/Sulbactam 17.2%,cefpime 19.8%.The drug resistance rates of Pseudomonas aeruginosa to amipicillin/Sulbactam was 100%.The drug resistance rates of all G-bacteria to third generation of cefarosporins were above 50%.Conclusion：The rates of bacterial resistance and multi-drug resistance of gram-negative bacteria of lower respiratory tract of elderly patient is a serious problem in Changchun.It is important and urgent to carry out surveillance of bacterial resistance for appropriate using of antibiotics effectively.