2010～2012年我院ICU常见G^-杆菌耐药性变迁分析

Continuous surveillance of antimicrobial resistance of Gram-negative Bacteria in Intensive Care Unit

目的为临床合理选用抗菌药物提供依据。方法采用WHONET 5.6软件分析2010～2012年泸州医学院附属医院ICU革兰阴性(G-)杆菌分布情况,采用纸片法或MIC法测定病原菌对抗菌药物的敏感性。结果共检出病原菌613株,其中G-杆菌461株(占75.2%)。G-杆菌中鲍曼不动杆菌131株,占28.4%,铜绿假单胞菌111株(24.1%),肺炎克雷伯菌占83株(18%),大肠埃希菌50株(10.8%)。3年间铜绿假单胞菌对大多数抗生素的敏感性率有逐年上升趋势,鲍曼不动杆菌对各类抗生素的敏感率均较低,对头孢哌酮/舒巴坦的敏感率最高。肠杆菌科对大多数抗生素的敏感性有所升高,其中亚胺培南和阿米卡星的敏感性最高,产超广谱β-内酰胺酶(ES-BLs)的大肠埃希菌和肺炎克雷伯菌的分离率均有下降。结论 2010～2012年ICU常见G-杆菌的耐药性有所降低。

Objective To provide basis for the drug application. Methods WHONET 5.6 was applied for analysis of the distribution of Gram-negative bacilli and drug resistance from 2010 to 2012. Disc diffusion test or MIC test were used to detect the antimicrobial sensitivity of bacterial isolates from ICU patients. Results A total of 613 organisms were col- lected in the survey period, which included 46l （75.2%） Gram-negative strains. Aeinetobacter banmannii （28.4%） , Pseudomonas aeruginosa （24.1%） , Klebsiella pneumoniae （ 18% ） and Escheriehia coil （ 10.8% ） were the most common isolates. The susceptibility rate of Pseudomonas aeruginosa to most of antibiotics increased year by year, but the sensitive rate of Acinetobacter baumannii to all antibiotics was low except for cefoperazone/sulbactam. The susceptibility rate of En- terobacteriaceae to most of antibiotics had the rising trend. The most susceptible antibiotics were imipenem and amikacin. The prevalence of ESBLs decreased in Eseherichia coli and Klebsiella pneumoniae. Conclusions The resistance of Gram- negative strains have gradually declined.