医院肠杆菌科细菌耐药谱分析

Drug resistance spectrum of Enterobacteriaceae

目的了解医院常见肠杆菌科细菌的耐药性动态趋势,为临床医师合理用药提供参考。方法收集2009年1月-2011年12月医院住院患者中分离出的2437株病原菌,应用细菌鉴定仪及药敏板进行细菌鉴定及药敏试验。结果检出肠杆菌科细菌1190株,占48.83%,其对碳青霉烯类抗菌药物亚胺培南和美罗培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦的耐药率一直保持在较低水平,耐药率为0～8.65%,而对大多数β-内酰胺类抗菌药物的耐药率一直维持在较高水平,耐药率为>70.00%,其中对氨苄西林的耐药率最高,2009、2011年各年的耐药率均>90.00%。结论医院肠杆菌科细菌的检出率一直维持在较高水平;亚胺培南、美罗培南、哌拉西林/他唑巴坦及头孢哌酮/舒巴坦可作为经验性治疗肠杆菌科细菌引起的重症感染的首选抗菌药物。

OBJECTIVE To investigate the dynamic trend of the drug resistance of Enterobacteriaceae so as to provide reference for the reasonable use of antibiotics. METHODS A total of 2437 strains of pathogenic bacteria were isolated from the hospitalized patients between Jan 2009 and Dec 2011, and the bacterial identification and the drug susceptibility testing were performed by using bacterial identification system and the drug susceptibility plate. RESULTS There were totally 1190 （48.83 %） strains of Enterobacteriaceae isolated, the drug resistance rates to carbapenems such as cefoperazone-sulbactam, imipenem, meropenem, and piperacillin-tazobactam varied from 0 to 8.65 %, the strains remained highly resistant to most of the β-lactam antibiotics with the drug resistance rate more than 70.00%, the drug resistance rate to ampicillin was the highest, which was higher than 90.00% in 2009 and 2011. CONCLUSION The detection rate of the Enterobacteriaceae remains at a high level in this area. Imipenem, meropenem, cefoperazone-sulbactam, and piperacillin-tazobactam can be used as the preferred antibiotics for the empirical treatment of severe infections caused by the Enterobacteriaceae.