2007—2009年广州医学院第三附属医院常见革兰阴性菌耐药性研究

Drug Resistance of Common Gram-negative Bacteria in the Third Affiliated Hospital of Guangzhou Medical College During the Period of 2007-2009

目的:了解我院2007—2009年常见革兰阴性菌耐药的情况,为临床合理选用抗菌药物提供参考依据。方法:收集我院细菌室2007年1月—2009年12月在临床标本中分离革兰阴性菌,分析它们的分布及耐药情况。结果:2007—2009年共分离了2 501株革兰阴性菌,检出比例在前4位的革兰阴性菌有大肠埃希菌635株(25.39%)、铜绿假单胞菌483株(19.31%)、肺炎克雷伯菌437株(17.47%)、鲍曼不动杆菌349株(13.95%),这4种菌占所检出的革兰阴性菌的76.12%。大肠埃希菌和肺炎克雷伯菌对碳青霉烯类、阿米卡星、头孢替坦、哌拉西林/他唑巴坦保持高度敏感性;铜绿假单胞菌对美罗培南、亚胺培南、阿米卡星、头孢他定、哌拉西林/他唑巴坦敏感性较高;除了碳青霉烯类、阿米卡星和多粘霉素B对其保持较高的敏感性外,其余的药物对其敏感率都下降到50%以下。结论:应当严格掌握适应证,动态监测本院细菌分布和耐药性的特点,合理使用抗菌药物才能有效控制耐药细菌的产生。

OBJECTIVE： To probe into the drug resistance profile of common gram-negative bacteria in our hospital during the period 2007-2009 so as to provide references for clinical rational use of antibiotics.METHODS： The gram-negative bacteria isolated from clinical specimens between Jan.2007 and Dec.2009 in the bacterial room were collected for analysis of the bacterial distribution and the drug resistance.RESULTS： A total of 2 501 strains of gram-negative bacteria were isolated between 2007 and 2009,leading the first 4 places in terms of the detection rate were Escherichia coli with 635 strains（25.39%）,Pseudomonas aeruginosa 483 strains（19.31%）,Klebsiella pneumoniae 437 strains（17.47%） and Acinetobacter baumannii 349 strains（13.95%）.The four kinds of bacteria represented 76.12% of total gram-negative bacteria detected.Escherichia coli and Klebsiella pneumoniae were highly sensitive to carbapenems,amikacin,cefotetan,piperacillin /tazobactam.Pseudomonas aeruginosa were highly sensitive to meropenem,imipenem,amikacin,ceftazidime,piperacillin /tazobactam.The antibiotic sensitivity rates of the gram-negative bacteria were less than 50% to all the other drugs but which were sensitive to carbapenems,amikacin and polymyxa B.CONCLUSION： Strictly following indications,dynamical monitoring bacteria distribution and drug resistance profile in our hospital and rational use of antibiotics are fundamental for effective control of the resistant bacteria from emergence.