我院2006年革兰阴性杆菌感染的耐药性分析

Drug resistance of gram-negative bacilli in this hospitail in 2006

目的了解我院临床分离的革兰阴性杆菌分布及耐药性特征,指导临床合理使用抗菌药。方法用纸片扩散法对各类感染标本中分离的革兰阴性杆菌共744株进行药敏试验,并用表型确证试验进行ESBLs的检测。结果我院分离的革兰阴性杆菌主要为大肠埃希菌(39.0%)、铜绿假单胞菌(21.5%)、肺炎克雷伯菌(17.3%)。这些菌株对12种抗生素的敏感率各不相同,亚胺培南仍是对革兰阴性杆菌抗菌作用最强的一类抗生素,头孢哌酮/舒巴坦、哌拉西林/他唑巴坦也有较好的抗菌活性。产酶菌株对抗菌药物的敏感率显著降低。结论我院分离的革兰阴性杆菌耐药性强且多重耐药,临床实验室应加强对ESBLs的检测,了解各菌种的耐药特点,以指导临床合理使用抗菌药物并严密监控新的耐药菌的产生。

Objective To investigate the distribution and drug resistance of gram - negative bacilli in clinical specimens in 2006, helping rationaluse of antibiotic in clinical practice. Methods Antfimicrobial susceptibility tests were done on 744 strains of gram - negative bacilli isolated by Kirby- Bauer method, the detection of ESBLs （extended- spectrum β- lactamases） - producing strains was performed for screening and confirming the presence of ESBLs. Results The majority of isolated gramnegative bacilli was Escherichia coli（ 39.0% ）, Pseudomonas aeruginosa （21.5 % ）, and Klebsiella pneumoniae （ 17.3 % ）. The susceptibilities of these strains to 12 antibiotic were different. Imipenem was the most active antimicrobias against gram - negative bacilli; cefoperazone/sulbactam and piperacillin/tazobactam also showed excellent activity. Their susceptibility was remarkably lower than that of ESBLs negative strains. Conclusions Drug resistance of gram - negative bacilli is high and multiple. It is important to detect ESBLs in clinical laboratory, helping rational use of antibiotics in clinical practice.