阴沟肠杆菌的临床分布及耐药性分析

Clinical distribution and drug resistance of Enterobacter cloacae

目的了解医院感染阴沟肠杆菌的临床分布及耐药性,为临床医师合理用药提供依据。方法回顾性分析医院2010年1月-2011年3月临床分离的154株阴沟肠杆菌的感染现状及耐药性。结果阴沟肠杆菌主要分布于糖尿科、肿瘤科及ICU,分别占50.00%、15.58%、12.99%;在各类标本中的构成比以创面分泌物、痰液较高,分别占64.29%、16.23%;阴沟肠杆菌对亚胺培南耐药率最低为0,对头孢吡肟、左氧氟沙星、阿米卡星耐药率相对较低,分别为25.32%、31.82%、36.36%;对氨苄西林、头孢唑林、氯霉素耐药率相对较高,分别为96.10%、92.21%、78.57%;阴沟肠杆菌产AmpC酶阳性率为46.10%。结论阴沟肠杆菌多药耐药现象较为严重,应加强耐药性监测指导临床医师合理使用抗菌药物。

OBJECTIVE To investigate the clinical distribution and drug resistance of Enterobacter cloacae causing nosocomial infections and provide basis for the clinical application of the antibiotics. METHODS The infection status and drug resistance of 154 E. cloacae from Jan. 2010 to Mar. 2011were retrospectively analyzed. RESULTS E. cloacae isolates were mainly isolated from the department of diabetics （50. 00M）, department of tumor （ 15.58 % ）, and ICU （ 12.99 % ）. Among various specimens collected, the wound secretions and sputum accounted for 64. 290/00 and 16.23% respectively. E. cloacae has the lowest drug resistance rate to imipenem which was 0, and has relatively low resistance rates to cefepime, levofloxacin, and amikacin, which were 25.32%, 31. 820/00 and 36.36 %, respectively; the resistance rates of E. cloacae to ampicillin, cephazolin, and minocycline were relatively high, which were 96.10%, 92.21% and 78.57%, respectively. The positive rate of AmpC-producing E. cloacae was 46. 10%. CONCLUSION Multidrug-resistance of E. cloacae is serious, it is necessary to strengthen the surveillance for drug resistance in order to guide the reasonable use of antibiotics.