我院下呼吸道感染病原菌耐药谱的研究

Drug susceptibility and resistant mechanisms of 2285 strains of clinical isolates from patients with lower respireatory tract infection

目的了解医院临床下呼吸道标本分离病原菌的耐药谱与耐药机制,为合理用药提供依据。方法分离的病原菌用VITEKⅡCampack鉴定,药敏用K-B法,数据分析用WHONET5.4软件。结果2285株病原菌中前5位为铜绿假单胞菌(20.3%)、金黄色葡萄球菌(10.8%)、肺炎克雷伯菌(8.7%)、鲍曼不动杆菌(8.7%)、大肠埃希菌(6.2%);在G-杆菌中,头孢哌酮\舒巴坦耐药率最低(6.8%),美罗培南耐药率为23.5%,大肠埃希菌和肺炎克雷伯菌产ESBLs的阳性率分别为42%和33.2%;G+球菌中,万古霉素和替考拉宁敏感率均为100%,金黄色葡萄球菌和凝固酶阴性葡萄球菌耐苯唑西林分别为85.1%和85.2%。结论医院临床分离病原菌产ESBLs和耐苯唑西林比率高,应加强抗菌药物的合理使用和采取有效的隔离措施以降低耐药率及多药耐药菌的扩散。

Objective To investingate the drug susceptibility of strain clinical isolates from patients with lower respiratory tract infection in local region for using antibiotic reasonably. Methods Totally 2285 strains of clinical isolates were identifyied by VITEK Ⅱ Campack and tested for drug resistance against antimicrobial agents by K-B method. WHONET5.4 was applied for analysis. Results The commonly encountered bacteria were Pseudomonas aeuginosa （ 20. 3% ）, Staphylococcus aureus （ 10. 8%）, Klebsiella pneumoniae（8.7 % ）, Acinetbacter baumannii （8.7% ）, Escherichia coil （ 6.8% ）. In Gram negative isolates, the resistance rate to cefoperazone-sulbactam……was 6.8% ,and to meropenem was 23.5%. The incidences of E. coil and K. pnemoniae isolates producing extended specttum beta-lactamases were 42% and 33.2%, respectively. In Gram-postive isolates, the susceptibility rate both vancomycin and teicoplanin of was 100%. The oxacillin resistant rates of Staphylococcus aureus and coagulase negative Staphylococcus were 85.1% and 85.2. Conclusion The production ratio of ESBLs and oxacillin resistance of bacteria in local region are high. It is important to promote the rational use of antimicrobial agents and take effective contaminant methods to reducee resistant tates of bacteria and dissemination of multi resistant bacteria.