延安市人民医院阴沟肠杆菌临床分布特点及药敏分析

Clinical Distribution and Drug Sensitivity Analysis of Enterobacter Cloacae in Our Hospital

目的了解我院阴沟肠杆菌临床分布特点及药敏情况,以指导临床合理用药。方法在科室老师指导下,对临床所送的合格标本按照《全国检验技术操作规程》的要求接种、分离、培养,采用Walkaway40型全自动细菌鉴定仪进行鉴定及药物敏感检测,微量生化反应及K-B法辅助检测。结果从327株革兰阴性菌株中分离出阴沟肠杆菌42株(12.84%);神经外科12株(28.57%),骨外科10株(23.81%);痰液22株(52.38%),分泌物14株(33.33%)。药敏结果显示,42株阴沟肠杆菌对亚胺培南全部敏感,加替沙星、哌拉西林/他唑巴坦、左氧氟沙星、丁胺卡那霉素的耐药率分别为21.43%、26.19%、26.19%、28.57%,复方新诺明和环丙沙星的耐药率在40%左右,其余抗生素耐药率都在50%以上。以头孢他啶/克拉维酸为ESBLs检测纸片,阳性率为76.19%。结论阴沟肠杆菌主要分布于神经外科和骨外科,容易引起患者呼吸道和伤口感染;产酶率高,具有高耐药和多重耐药特点,应引起临床注意,合理选择抗生素。

Objective To investigate the clinical distribution and drug sensitivity situation caused by Enterobacter cloacae in our hospital,for guiding the clinical application of antibiotics reasonably.Methods Under the guidance of teachers in the department,the qualified clinical specimens were sent to be vaccinated,isolatedand and cultued in accordance with ＂National Laboratory Technical Operation Requirements＂.Enterobacter cloacae bacteria were identified by Walkaway40 automatic analysis system of bacteria and susceptibility detected by hand-assisted detection of biochemical and K-B method.Results 42 strains of Enterobacter cloacae were isolated from the 327 negative bacteria,mainly distributed in neuro surgery and orthopedic surgery,the percentages of these strains isolated from sputum and secretions were 52.38%and 33.33%.42 strains of Enterobacter cloacae were all sensitive to imipenem The percentages of isolates resisted to gatifloxacin,piperacillin/tazobactam,levofloxacin,kanamycin were 21.43%.26.19%,26.19%,28.57%,40% isolates resisted to ciprofloxacin and sulfamethoxazole.To the rest of antibiotic resistance,the percentages of isolates resisted were more than 50%.To ceftazidime/clavulanic acid for the detection of ESBLs paper,the positive rate was 76.19%.Conclusion These strains of Enterobacter cloacae are distributed mainly in neurosurgery and orthopedic surgery;easily cause infections of respiratory tract and wound;Enzyme production rate is high,Its high resistance and multiple drug resistance should cause clinical attention,It suggests that the selection of antibiotics should be reasonable.