柳州市工人医院呼吸病房2009年1月—2012年12月革兰阴性菌的分布与耐药性分析

Analysis on distribution and drug resistance of Gram-negative bacteria in respiration department of Liuzhou Worker's Hospital from January,2009 to December,2012

目的分析广西柳州市工人医院2009年1月—2012年12月呼吸病房常见革兰阴性菌的分布及对抗菌药物的耐药情况,为临床医师合理用药提供可靠依据。方法对2009年1月—2012年12月柳州市工人医院呼吸病房送检分离出的病原菌菌株及其耐药性进行回顾性调查分析。结果共分离出常见的革兰阴性菌1434株,主要以肺炎克雷伯菌和鲍曼不动杆菌为主,分别占25.9%、19.7%;大肠埃希菌和铜绿假单胞菌检出率分别17.0%、12.6%。大肠埃希菌和肺炎克雷伯菌超广谱β-内酰胺酶(ESBLs)的平均检出率分别为34.4%、54.9%。大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌对亚胺培南、美罗培南和哌拉西林/他唑巴坦保持较高的敏感性,敏感率为65%～100%。鲍曼不动杆菌、铜绿假单胞菌对多数抗菌药物高度耐药,且呈逐年上升趋势。结论不同的革兰阴性菌对各类抗菌药物的耐药性存在差异,应加强革兰阴性杆菌耐药性的动态监测,为临床医师合理使用抗菌药物提供科学依据。

Objective To analyze the distribution and drug resistance of Gram-negative bacteria in the Respiration Department of Liuzhou Worker’s Hospital from January,2009 to December,2012,in order to provide the reliable basis for clinical rational drug use.Methods Bacteria strains separated from the Respiration Department of Liuzhou Worker’s Hospital from January,2009 to December,2012 and their drug resistance were studied,respectively.Results All of 1 434 Gram-negative bacteria were separated and the main strains were Klebsiella pneumoniae（25.9%）,Acinetobacter baumannii（19.7%）,Escherichia coli（17.0%）,and Pseudomonas aeruginosa（12.6%）.The average detection rates of extended-spectrum beta-lactamases（ESBLs） in K.pneumoniae and E.coli were 34.4% and 54.9%,respectively.E.coli,K.pneumoniae.and Enterobacter cloacae kept high sensibility to imipenem,meropenem,and piperacillin/tazobactam,and the sensitivity rate was 65%—100%.A.baumannii and P.aeruginosa kept high resistance to the most antibiotics and increased year by year.Conclusion The antimicrobial resistance of Gram-negative bacteria is different,so we should strengthen dynamic monitoring on drug resistance of Gram-negative bacteria,in order to provide the scientific basis for the clinical rational usage of antimicrobial drug.