2009年贵州省黔南地区革兰阴性杆菌耐药监测分析

Monitoring to drug resistance of Gram-negative bacillus from Qiannan Area,Guizhou in 2009

目的了解医院常见革兰阴性杆菌的分布和耐药性,为临床合理用药提供依据。方法收集2009年1月-2009年12月从住院患者分离的562株革兰阴性杆菌,采用VITEK、Microscan等微生物分析鉴定系统进行菌种鉴定;采用K-B法对细菌作药敏试验。结果分离率居前5位的革兰阴性杆菌依次为:大肠埃希菌、其他肠杆菌科细菌、肺炎克雷伯菌、鲍氏不动杆菌、铜绿假单胞菌,分别占34.3%、18.9%、17.4%、12.1%、6.2%,产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌检出率分别为52.8%和34.2%,其余革兰阴性杆菌均显示了不同程度的耐药性,铜绿假单胞菌对头孢曲松和氨曲南的耐药率>60.0%,鲍氏不动杆菌对头孢曲松和哌拉西林的耐药率>60.0%。结论医院检验科务必做好感染病原菌的动态监测,为临床医师合理使用抗菌药物提供科学依据。

OBJECTIVE To analyze the distribution and the features of drug resistance of the commonly occurred Gram-negative bacillus in order to provide the methods for clinicians to use antibiotics on patients rationally.METHODS A total of 562 samples separated from patients in hospital who were affected by Gram-negative bacillus were collected from Jan to Dec 2009.Then,the pathogens were identified by adopting VITEK,Microscan and other microbiological analysis system.At the same time,K-B analysis was also applied to test the drug sensitivity.RESULTS The top 5 isolation rates of Gram-negative bacillus in turn were： Escherichia coli（34.3%）,Enterobacter（18.9%）,Klebsiella pneumoniae（17.4%）,Acinetobactor baumannii（12.1%） and Pseudomonas aeruginosa（6.2%）.The detection rates of ESBIs-producing E.coli and K.pneumoniae were respectively 52.8% and 34.2%.And the rest of Gram-negative bacillus showed drug resistance at various degree.The resistance rates of the P.aeruginosa to ceftriaxone sodium（Rocephin） and aztreonam was higher than 60.0%.The resistance rate of ABA to ceftriaxone sodium（Rocephin） and piperacillin was over 60.0%.CONCLUSION Dynamic monitoring to the pathogenic bacteria causing infection should be well conducted to provide scientific evidence for clinicians to use antibiotics reasonably.