重症监护病房与非重症监护病房粘质沙雷菌耐药性比较

Comparison of drug-resistance of Serratia marcescens between ICU and non-ICU

目的了解重症监护病房(ICU)与非重症监护病房粘质沙雷菌耐药情况,指导抗生素的合理应用。方法收集2009年至2010年永康市第一人民医院ICU病房送检标本中分离到的33株粘质沙雷菌与同期非ICU病房送检标本中分离到的26株粘质沙雷菌,对其耐药性进行回顾性分析。结果 ICU与非ICU分离的粘质沙雷菌,除均对头孢他啶、庆大霉素、亚胺培南、左氧氟沙星、哌拉西林/他唑巴坦、复方新诺明耐药外,ICU粘质沙雷菌对氨苄西林/舒巴坦、氨曲南、头孢曲松、头孢唑啉耐药率明显高于非ICU病房(P<0.05),差异有统计学意义。结论 ICU粘质沙雷菌耐药率明显高于非ICU。应及时对ICU患者进行抗生素耐药性检查,根据药敏试验结果选用抗生素,细菌耐药率少于30%的抗菌药物,首先选用,但要考虑感染程度及器官功能状态;耐药率大于75%的药物暂停使用。

Objective To investigate the drug resistance of Serratia marcescens isolated from ICU and non-ICUs,and provide evidences for the clinical reasonable application of antibiotics.Methods From January 2009 to December 2010,33 strains of Serratia marcescens isolated from ICU and 26 strains from non-ICUs were evaluated by Microscan-Walkaway 40（American Dade Behring） and their MICs were determined by combined bacterial identification/medicine sensitive analyzer.Statistical retrospective analysis of drug resistance results was conducted.Results Serratia marcescens isolated from both the ICU and non-ICUs were resistant to Ceftazidime,Gentamicin,Imipenem,Levofloxacin,Piperacillin/Tazobactam and Trimethoprim-Sulfamethoxazole.In addition,the pathogens from ICU were more resistant to Ampicillin/Sulbactam,Aztreonam,Ceftriaxone and Cefazolin than those from non-ICUs（P0.05）.Conclusion The rate of drug resistance of ICU Serratia marcescens is higher than that of the non-ICUs.Clinicians should select effective antibiotics according to the results of drug resistance test combined with the infection severity and organ functional status.Those antibiotics to which the resistance rate are less than 30% shall be the first choice,and the ones more than 75% be suspended.