2010～2011年度我院多重耐药细菌的分布及耐药性分析

Diversity on the distribution and drug resistance of the multiple drug resistance bacteria of our hospital from 2010 to 2011

目的了解我院2010～2011年度多重耐药细菌的分布及常见抗菌药物耐药率的变迁。方法对2010～2011年度我院住院病人送检标本中分离的多重耐药菌157株,用纸片扩散法进行药物敏感试验,并对致病菌耐药率的变迁情况进行分析。结果 157株病原菌中,G+菌40株,以金黄色葡萄球菌为主;G-菌117株,其分布依次为大肠埃希菌,鲍曼不动杆菌,铜绿假单胞菌,其他G-多重耐药菌。在菌群变迁中G-菌分离率总体上呈下降趋势,G+菌则相反,不同菌种在不同时间段分布差异有显著性意义(P<0.05);大肠埃希菌均为超广谱β内酰胺酶阳性(ESBL+)菌株,对头孢他啶耐药,对亚胺培南敏感,对头孢西丁中度敏感;铜绿假单胞菌对多数抗菌药物保持较高耐药率,耐药率最低的依次为哌拉西林/他唑巴坦,亚胺培南,米诺环素;鲍曼不动杆菌中以泛耐药鲍曼为主,对除了多粘菌素B外的其他抗菌药物完全耐药;金黄色葡萄菌对万古霉素保持较高的敏感性,未检出耐万古霉素肠球菌。结论我院糖肽类抗生素对G+菌;碳青霉烯类,β内酰胺/β内酰胺酶抑制剂复方药物对G-菌保持相对较高的抗菌活性,但泛耐药鲍曼的产生日益成为我院临床抗感染治疗中面临的新的难题。

Objective To investigate pathogen distribution and the drug resistance in patients of our hospital from 2010 to 2011. Methods From 2010 to 2011, 157 multiple drug resistance bacterial were isolated from specimen of inpatients, and then the drug resistance was determined by agar disc dif- fusion method and all results were analyzed. Results 157 pathogens were isolated, Gram-positive bacteria amounted for 40, with Staphylococcus aureus predominated. Gram-negative bacteria amounted for 117, the distribution were Escherichia coil, Acinetobacter bauman Pseudomnnas aeruginsa, other Gram -negative bacteria, in flora vicissitude, isolating rates of the gram-negative bacteria was downturn in general; on the contrary, the gram-positive bacteria was upgraded. The difference of distribution of bacteria was significant in different time （P〈 0.05）. Eseheriehia coli all positive with extended sperc trum beta lactamases, were resistant to ceftazidine, but sensitive to imipenem, mild sensitive to cefoxitin： Pseudomnnas aeruginsa maintained high rate of resistance to most antibiotics. The lowest rate of drug resistance were piperacillin tazobactam. Imipenem, minoeyline; Acinetobacter bauman mostly were pan drug resistance which were resistant to all antibiotics excerpt polymyxin B; Staphylococcus aureus maintained high rate sensitivity to vancomycin, undetected vancomycin-resistant enterocoecus. Conclusions The glycopeptides antibiotics for gram positive bacteria, carbapenem, beta-lactam/beta lactamamase inhibitor compound drug on gram negative bacteria remain relatively antibacterial activity, but pan drug resistance Acinetohacter bauman has increasingly become new problem for anti-infection treatment in our hospital.