临床分离主要革兰阴性杆菌分布及耐药状况

Eparation of Gram-negative bacillus Main Distribution and Resistance

目的了解临床送检各类标本中分离的主要G-杆菌分布及耐药情况,为临床抗感染治疗和合理使用抗菌药物提供依据。方法将临床送检的痰液、血液,泌尿道、创面分泌物、体液等各类标本按常规分离培养,用VITEK-ATB分析系统鉴定菌种,药敏试验数据采用K-B纸片法,按NCCLS规定标准进行判断。结果2006年7月-2007年6月共分离临床各类标本主要G-杆菌707株,居前3位是大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌,对16种抗菌药物均有不同程度耐药;其中3种主要肠杆菌科细菌对亚胺培南耐药率均为0,对氨苄西林高度耐药,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦耐药率在3.3%～34.0%;在非发酵菌中,除嗜麦芽寡养单胞菌对亚胺培南天然耐药外,其余对亚胺培南耐药率均<10.2%;产超广谱β-内酰胺酶(ESBLs)菌株的耐药性明显增高。结论临床医生应关注耐药菌株出现,根据药敏试验结果进行个体化、合理化选用抗菌药物,以控制和降低耐药菌株的产生。

OBJECTIVE ： understand all types of hospital clinical specimens sent from the main Gram-negative bacillus distribution and resistance, for clinical anti-infection treatment and provide the basis for the rational use of antibiotics. METHODS Clinical submitted the sputum, Blood, Urinary tract secretions, Wound secretions, Humoral ere all kinds of specimens from the conventional training, use Viekt-ATB auto-system, and K-B paper disk diffusion in accordance with NCCLS standards was employed for drug sensitivity tests. RESULTS July 2006 June 2007 Clinical specimens were isolated various major G-Bacillus 707, Habitat of the top three are： Escherichia coli, Klebsiella pneurnoniae, Pseudomonas aeruginosa, 16 kinds of antibiotics resistance in varying degrees, three major imipenem Enterobacteriaceae bacteria resistant rates are 0. 0%, Highly resistant to ampicillin, to cefoperazone/sulhactam, piperacillin/tazobactam resistance rate of 3.3% to 34.0%. In non-fermented bacteria,In addition to Stenotrophomonas maltophilia Aeromonas natural resistance to imipenem,The remaining resistance to imipenem rate of 〈10.2%. ESBLs β-lactamase resistant strains increased significantly. CONCLUSIONS Clinicians should, concerned about drug resistant strains appear, according to test results of individual susceptibility, rationalize the choice of antibiotics, to control and reduce the formation of drug resistant strains.