171例革兰阴性杆菌感染及其药敏结果分析

Analysis of infection statue of gram negative bacilli and their drug susceptibility results in 171 patients

目的研究本院患者下呼吸道革兰阴性杆菌感染情况并分析其耐药趋势,为临床治疗提供用药依据。方法用美国MICROSCAN细菌分析软件对171例下呼吸道感染标本行细菌分析鉴定,并对其耐药情况进行分析。结果2005年1月至2006年8月底来本院的细菌培养标本中,共分离出致病性革兰阴性杆菌菌株171株,按菌株多少前5位依次为:铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌及阴沟肠杆菌,占有率分别为:26.9%(46株)、22.8%(39株)、21.6%(37株)、8.2%(14株)和7.6%(13株)。药敏结果显示,分离革兰阴性杆菌对临床常见抗生素最敏感的是:哌拉西宁/他唑巴坦(特治新)及头孢哌酮/舒巴坦(舒普森),敏感率分别为94.6%和93.8%;耐药率最高的分别为头孢唑啉和头饱呋新(82.2%和74.6%)。部分肠杆菌对多种抗生素呈现多重耐药倾向。结论下呼吸道感染之革兰阴性杆菌中,以铜绿假单胞菌、肺炎克雷伯菌等为常见致病菌。部分肠杆菌对多种抗生素呈现多重耐药倾向,依据药敏试验结果科学、合理使用抗生素,是减少细菌耐药并治疗成功的关键。

Objective The aim of the study is to investigate the infection statue of gram negative bacilli from and their drug resistance tendency in patients with lower respiratory tract infection in our hospital, and to provide evidence for clinical administration. Methods MICROSCAN bacteriological analysis software was applied to performing bacteria identification and drug resistance analysis for 171 samples from lower respiratory tract infection patients. Results A total of 171 strains of pathogenic gram negative bacilli were isolated from the delivered bacterial culture samples from Jan 2005 to the end of Aug 2006 in our hospital. The detection rates in order were 26.9 % for Pseudomonas aeruginosa, 22, 8% for Klebsiella pneumoniae, 21.6% for Acinetobacter baumannii, 8, 2% for Escherichia coli, and 7.6%for Enterobacter cloacae, Drug susceptibility test showed the most sensitive antibiotic to isolated gram negative bacilli was avocin/tazobactam （bezhixin） （94, 6 %）, followed by cefoperazone/sulbactam （superanzon） （93.8%） ; the most resistant antibiotic was cefazolin （82.2%）, followed by cefuroxime （74, 6%）, Partial Enterobacteriaceae displayed multidrug resistant tendency to several antibiotics. Conclusion Pseudomonas aeruginosa and Klebsiella pneumoniae are common pathogenic gram negative bacilli in patients with lower respiratory infection, Partial Enterobacteriaceae displays multidrug resistant tendency to several antibiotics, Rational use of antibiotics according to susceptibility test results is the key to reduction of drug resistance and successful treatment.