2002-2007年临床常见革兰阴性杆菌耐药性分析

Drug Resistance of Clinical Gram-negative Bacilli Isolated From 2002 to 2007

目的了解临床常见革兰阴性杆菌耐药性变迁。方法对2002-2007年临床分离出的常见革兰阴性杆菌耐药性进行回顾性分析,细菌鉴定采用API鉴定系统,药敏试验采用纸片扩散法,数据采用WHONET5软件进行统计分析。结果6年来,医院常见肠杆菌科细菌依次为大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌,常见非发酵菌依次为铜绿假单胞菌、鲍氏不动杆菌和嗜麦芽寡养单胞菌;阿米卡星对肺炎克雷伯菌的耐药率2006-2007年(23.0%)与2002-2003年(39.9%)比较有明显降低(P<0.05),亚胺培南对铜绿假单胞菌的耐药率2006-2007年(36.8%)与2002-2003年(22.0%)相比有明显增高(P<0.05);多种抗菌药物尤其是头孢菌素类耐药率有逐渐增加趋势。结论医院常见革兰阴性杆菌多药耐药现象严重,应合理用药,避免或减少耐药性的发生。

OBJECTIVE To investigate the antimicrobial resistance of clinical gram-negative bacilli isolated from 2002 to 2007. METHODS The clinical gram-negative bacilli and their drug-resistance were analyed retrospectively. These bacteria were identified with API analysis system and disc diffusion tests were employed to study the antimicrobial resistance which was analyed by the software ＂WHONET-5＂. RESULTS In resent 6 years, E. coli, K. pneumoniae and E. cloacae were most common among enterobacteriaceae. P. aeruginosa,A, baumannii and S. maltophilia were most common among non-fermentative bacteria. The drug resistance rate of amikacin against K. pneurnoniae in 2006--2007 （23.0%） was lower than that in 2002--2003 （39.9%）. The rate of imipene against P. aeruginosa in 2006--2007 （36. 8%）was higher than in 2002--2003（22%） （P〈0.05）. The tendency of drug resistance to several antibiotics, especially eephalosporins, increased gradually year by year. CONCLUSIONS The multidrug resistant phenomenon in these clinical gram-negative bacilli is very common. The physician shoud use antibiotics properly and reduce the production of drug resistant stains.