某院革兰阴性杆菌耐药性监测及其临床意义

Surveillance of antimicrobial resistance in clinical isolates of Gram-negative bacilli and its clinical significance

目的分析该院2010年度临床分离革兰阴性杆菌的耐药状况,为临床合理使用抗菌药物提供依据。方法常规方法培养分离医院内感染病原菌,并应用全自动细菌鉴定分析仪鉴定到种,采用WHONET5.4软件进行数据统计分析。结果该院共分离出革兰阴性杆菌445株,其中大肠埃希菌111株,铜绿假单胞菌109株,鲍曼不动杆菌84株,肺炎克雷伯菌69株。药敏监测结果显示,大肠埃希菌和肺炎克雷伯菌对哌拉西林和氨苄西林耐药,对美罗培南、亚胺培南、厄他培南、替加环素敏感。铜绿假单胞菌对头孢替坦、复方新诺明、氨苄西林耐药,对阿米阿星和他唑巴坦较为敏感,鲍曼不动杆菌对头孢唑林、头孢西丁、头孢呋辛钠、呋喃妥因耐药,对美罗培南敏感。结论革兰阴性杆菌对多种抗菌药物的耐药率呈现上升趋势,临床微生物实验室应加强对多重耐药菌的监测,为临床正确合理使用抗菌药物提供依据。

Objective To investigate flora distribution and drug resistance status of Gram-negative bacilli in this hospital and provide scientific evidence for clinically reasonable use of antibiotics.Methods Gram-negative bacilli were clinically isolated from various infective specimens.The stain isolations were identified by using full automated analyzer.All data were statistically analyzed with WHONET5.4software.Results 455strains of Gram-negative bacilli were insolated,the top four common strains were Escherichia coli（111strains）,Pseudomonas aeruginosa（109strains）,Acinetobacter baumannii（84strains） and Klebsiella pneumoniae（69 strains）.Escherichia coli and Klebsiell pneumoniae were sensitive to meropenem,imipenem,ertapenem and tigecycline,but resistant to piperacillin and ampicillin.Pseudomonas aeruginosa was sensitive to amikacin and tazobactam,but resistant to cefotetan.SMZTMP and ampicillin.Acientbacter baumannii was sensitive to meropenem,but resistant to cefazolin,cefoxitin,cefuroxime sodium and nitrofurantoin.Conclusion Drug resistance status of Gram-negative bacilli might very serious.More attention should be paid for the detection of pathogens and drug resistance in hospital to prevent the outbreak.