临床常见革兰阴性菌的分布及其耐药性分析

Distribution and Drug Resistance of Gram-negative Bacilli in Clinics

目的探讨临床常见革兰阴性菌的分布及其耐药情况,为临床医师合理使用抗菌药物提供科学依据。方法对临床送检的各类标本严格按照《全国临床检验操作规程》进行分离培养,菌株鉴定采用法国生物梅里埃公司提供的VITEK32全自动微生物鉴定仪,药敏试验采用K-B纸片扩散法。结果 262株菌分离前4位的革兰阴性菌依次为肺炎克雷伯菌、大肠埃希菌、鲍氏不动杆菌、铜绿假单胞菌;肺炎克雷伯菌和大肠埃希菌对亚胺培南100.00%敏感,对哌拉西林/他唑巴坦的耐药率<26.00%,大肠埃希菌对呋喃妥因的耐药率为23.53%,铜绿假单胞菌对亚胺培南的耐药率为9.09%,而鲍氏不动杆菌对亚胺培南的耐药率为86.67%。结论临床常见革兰阴性菌多药耐药现象严重,应加强检测与控制。

OBJECTIVE To investigate the resistance and distribution of the Gram-negative bacilli and conduct the clinical medication.METHODS Gram-negative bacilli from the all sorts of samples were isolated and cultured by referring to Rules of Operation in Clinical Laboratory of Nationwide.The strains were identified by using the automatic microorganism analyzer VITEK-32,the bacterial drug susceptibility was performed by K-B method.RESULTS Totally 262 strains of bacteria were isolated by bacterial culture.Klebsiella pneumoniae was the most common,followed by Escherichia coli,Acinetobacter baumannii and Pseudomonas aeruginosa.The drug sensitivity tests showed that the resistance of K.pneumoniae and E.coli to imipenem were 100.00%,to piperacillin/tazobactam were less than 26.00%.The resistant rate of E.coli to nitofurantoin was 23.53%,the resistant rate of P.aeruginosa to imipenem was 9.09%,and the resistant rate of A.baumannii to imipenem was 86.67%.CONCLUSION The multi-drug resistant phenomenon in these common clinical Gram-negative bacilli is very serious,so the monitoring and control should be strengthened.