2008年大理学院附属医院肠杆菌科细菌耐药性监测

Surveillance of Antimicrobial Resistance in Clinical Isolates of Enterobacteriaceae from Affiliated Hospital of Dali University in 2008

目的:研究大理学院附属医院2008年临床分离肠杆菌科细菌的耐药状况,为更好地指导临床应用抗生素。方法:收集本院所分离的190株肠杆菌,分析其菌种来源、临床分布和耐药性。细菌分离、培养按常规方法,菌种鉴定采用Vitek-32全自动微生物分析仪,药敏试验采用K-B法。结果:190株肠杆菌科细菌中,菌种来源于口痰76株(40%)、尿液42株(22.1%)、消化道分泌物26株(13.7%)、其它46株(24.2%)。分离菌种前3位分别是大肠埃希菌103株(54.2%)、克雷伯菌属37株(19.5%)、肠杆菌属15株(7.9%)、其它35株(18.4%)。耐药性分析提示大肠埃希菌对头孢他啶/棒酸、阿米卡星、亚胺培南、氨苄西林/棒酸、哌拉西林/舒巴坦等耐药率较低,分别为5.2%、11.1%、11.3%、13.4%、14.3%;而对氨苄西林高度耐药,为78.9%。结论:临床分离的肠杆菌科细菌耐药性较严重,而头孢他啶/棒酸有一定的效果。

Objective： To investigate the antibiotic resistance of clinical isolates of enterobacteriaceae from Affiliated Hospital of Dali University to antimicrobial agents commonly used during 2008, and guide the clinical application of antimicrobial agents. Method： 190 strains of clinical isolated enterobacteriaceae were collected from Affiliated Hospital of Dali University. The sources of strains, clinical distribution and resistance were analyzed. The bacteria were isolated and cultured with general method. The identification of bacteria and susceptibility test were performed by using automatic bioanalysis Vitek-32 and Kirby-Bauer methods. Result： Of the colleted 190 clinical isolates, 76 strains were from phlegm （40%）, 42 strains from urine （22.1%） and 26 strains from secretion of digestive tract （13.7%）. The top three pathogens were E. coli （103 strains, 54.2%）, Klebsiella （37 strains, 19.5%） and enterobacter （15 strains, 7.9% ）, respectively. The resistance analysis indicated that E. coli resisted to many antibacterials with different resistance incidence; antibacterials with lower resistant incidence were ceftazidime/clavulanic acid （5.2%）, amikacin （ 11.1% ）, imipenem （ l 1.3% ）, ampicillin/clavulanic acid （ 13.4% ）, and piperacillin/sulbaetam （ 14.3% ）, while the 4 strains were highly resistant to ampicillin; the resistance rate was 78.9%. Conclusion： Clinical isolates of the family enterobacteriaceae have high rate of drug-resistance, while ceftazidime/clavulanic acid may have been certainly effectual.