我院2001～2008年临床分离革兰阴性杆菌构成及其耐药性分析

Composition of Clinically Isolated Gram-negative Bacilli and Drug Resistance in Our Hospital from 2001～2008

目的:为临床医师合理使用抗菌药物提供可靠依据。方法:对我院2001～2008年临床分离革兰阴性(G-)杆菌及耐药情况进行回顾性调查。结果:2001～2008年临床共分离的病原菌14428株,G-杆菌9391株,占65.1%,主要以大肠埃希菌、铜绿假单胞菌、阴沟肠杆菌、肺炎克雷伯菌及不动杆菌多见,其中鲍曼不动杆菌分离率逐年上升。G-杆菌对临床常用抗菌药物均有不同程度耐药,对氨苄西林普遍耐药率高;对亚胺培南、哌拉西林/他唑巴坦、阿米卡星耐药率较低。结论:G-杆菌构成及耐药谱在不断发生变化,临床医师应掌握细菌变迁及细菌耐药性变化动向,提高抗菌药物合理使用水平。

OBJECTIVE： To provide clinicians with reliable basis about rational use of antibacterials. METHODS： The gram-negative bacilli isolated clinically in our hospital from 2001 to 2008 and their drug resistance were analyzed retrospectively. RESULTS： A total of 14 428 strains of pathogenic bacteria were isolated from 2001 to 2008, of which, 9 391 strains （65.1%） were gram-negative bacilli, leading the list were Escherichia coli, Pseudomonas aeruginosa, Enterobacter cloacae, Klebsiella pneumoniae and Acinetobacter, and the detected rate of Acinetobacter baurnannii increased year by year. Gram-negative bacilli were resistant to commonly used antibacterials more or less, with their resistance rates to ampicillin on the high side, but their resis- tance rates to imipenem, pipercillin/tazobactam and amikacin were low. CONCLUSION： The composition of clinically isolated Gram-negative bacilli and their drug resistance patterns were always in a change, therefore, clinicians should familiarize with this change as well as the change of drug resistance and improve their level of rational use of antibiotics.