2011年多药耐药菌临床分布及耐用性分析

Distribution and drug resistance of clinically isolated multidrug-resistant bacteria in 2011

目的通过了解2011年全年多药耐药菌的临床分布及耐药性分析,为临床合理用药提供依据。方法回顾性分析2011年全院临床分离的381株多药耐药菌的临床分布及药敏结果。结果分离出的381株多药耐药菌依次为产ESBLs大肠埃希菌占37.8%,产ESBLs肺炎克雷伯菌28.8%,多药耐药铜绿假单胞菌占22.6%,多药耐药鲍氏不动杆菌占7.1%,产ESBLs产酸克雷伯菌占2.9%,MRSA占0.8%;ICU、老年病科、神经内科、神经外科、泌尿科分布比例较大;药敏结果显示,多药耐药菌对单环类、青霉素类、磺胺类、氨基糖苷类、喹诺酮类、第一～三代头孢类抗菌药物均有很大程度的耐药性。结论医院应严格根据微生物室的细菌耐药性监测结果合理选用抗菌药物,加强病原菌耐药性监测,采取相应措施控制耐药菌株的传播。

OBJECTIVE To understand the clinical distribution and drug resistance of multidrug-resistant bacteria in 2011,so as to provide basis for the clinical rational use of antibiotics.METHODS A total of 381 strains of clinically isolated multidrug-resistant bacteria were retrospectively analyzed,and the drug susceptibility testing was performed.RESULTS Of totally 381 strains of multidrug-resistant bacteria isolated,ESBLs-producing Escherichia coli accounted for 37.8%,ESBLs-producing Klebsiella pneumoniae 28.8%,Pseudomonas aeruginosa 22.6%,Acinetobacter baumannii 7.1%,ESBLs-producing Klebsiella oxytoca 2.9%,and MRSA 0.8%.The isolated strains distributed widely in the ICU,department of geriatrics,neurology department,neurosurgery department,and urology department.The drug susceptibility testing result proved that the multidrug-resistant bacteria were highly resistant to penicillins,sulfonamides,aminoglycosides,quinolones,and the first to third generation cephalosporins antibiotics.CONCLUSION The hospital should reasonably choose antibiotics according to the monitoring of bacterial resistance in the clinical laboratory,strengthen the monitoring of drug resistance of the pathogens,and take corresponding countermeasures so as to control the spread of the drug resistant strains.