手外科患者阴沟肠杆菌的检出及耐药性分析

Distribution and drug resistance of Enterobacter cloacae from hand surgery

目的调查医院手外科患者感染阴沟肠杆菌的状况及耐药性,以指导临床有效预防和合理治疗。方法对2007年1月-2009年12月手外科分离出的阴沟肠杆菌采用纸片扩散法(K-B法)进行药敏试验,并对阴沟肠杆菌耐药性进行总结分析。结果 2007年1月-2009年12月医院手外科共培养出病原菌365株,其中分离出阴沟肠杆菌93株,占25.5%,阴沟肠杆菌对头孢类、氨曲南及青霉素类抗菌药物表现为高耐药性,耐药率分别为60.2%～96.8%、68.8%、31.2%～81.7%,对喹诺酮类抗菌药物表现为中等耐药,耐药率为34.1%～43.3%,仅对碳青霉烯类抗菌药物敏感。结论临床应加强对阴沟肠杆菌的监控和预防,并根据药敏结果合理选用抗菌药物,减少耐药菌株的产生。

OBJECTIVE To investigate the drug resistance of Enterobacter cloacae isolated from hand surgery patients in our hospital, so as to guide the prophylactic and reasonable treatment in clinical practice. METHODS Analysis of the drug resistance situation of E. cloacae was made by Kirby-Bauer method from hand surgery between Jan 2007 and Dec 2009. RESULTS A total of 365 strains were isolated from Jan 2007 to Dec 2009, including 93 strains of E. cloacae,which were accounted for 25.5~ of the total separation. E. cloacae showed high resistance to cephalosporins（resistance rates： 60. 2~ -- 96. 8%）, aztreonam （resistance rates： 68. 8~） and penicillin（resistance rates ： 31. 2 % - 81. 7 %）, and medium resistance to quinolones antibiotics （resistance rates ： 34.1%- 43.3 %）, but all strains were sensitive to carbapenems. CONCLUSION More attention should be paid to the surveillance and prevention of such strains, it should reasonably choose antibiotics, on base of the result of antimicrobial susceptibility test, to reduce the drug resistant strains.