尿液中奇异变形杆菌耐药性变迁及监测分析

Variation of drug resistance of Proteus mirabilis isolated from urine

目的了解尿液中奇异变形杆菌临床分布及耐药性变迁情况，为临床医生合理选用抗生素提供理论依据。方法收集2008年至2012年住院及门诊患者尿液标本中分离的215株奇异变形杆菌，采用VITEK2 Compact全自动微生物分析仪进行鉴定及药敏试验,采用WH0NET 5.4软件进行统计分析。结果2008、2009、2010、2011和2012年分离奇异变形杆菌分别为26株（占12. 2% ）、26株（占12.2% ）、36株（占16. 9% ）、55株（占25. 8% ）和72株（占33. 8% ），总计215株。奇异变形杆菌对呋喃妥因的耐药率最高，均〉90%，对丁胺卡那霉素和美洛培南的耐药率最低，均为0%，对左旋氧氟沙星的耐药率在2008？2011年均〉50% ,2012年为28.1% ;对哌拉西林/他唑巴坦的耐药率在2008 - 2009年均〉20%，而2010-2012年均〈5% ;头孢替坦、舒普深耐药率均〈7%。结论奇异变形杆菌的分离率从2008 -2012年呈日益增长趋势，提醒我们随着临床上大量使用抗生素，医院的感染率亦不断上升。耐药率从2008-2011年基本呈上升趋势，而在2012年有所下降,这可能与近几年本院临床严格执行抗菌药物的合理应用有关。

Objective To study the clinical distribution and drug resistance of Proteus mirabilis isolated from urine, and provideguidance for clinical application of drug. Methods Collected from 2008 - 2012 hospitalization and outpatient urine specimens were isolated 215 strains of Proteus mirabilis,adopting VITEK 2 Compact automatic analyzer for identification and drug sensitive test, WHONET 5.4 software was used for statistical analysis. Results In 2008,2009,2010,2011 and 2012,the seperation from shows that Proteus mira-bilis were 26 strain （12. 2% ）,26 strain （12. 2% ）,36 strain （16. 9% ）,55 strain （25. 8% ） and 72 strain （33. 8% ）,respectively, atotal of 215 strains. The drug resistance rate of Proteus mirabilis in 2008 - 2012 to nitrofurantoin 〉 90%,to amikacin and meropenemwere lowest, both 0%,to levofloxacin from 2008 to 2011 year 〉 50% , 28. 1% in 2012 ; to piperacillin/tazobactam from 2008 to 2009 〉 20%,and 2010 to 2012 annual 〈5% ; to cefotetan, sulperazon 〈1% . Conclusion Proteus mirabilis separation rate from 2008 to 2012is in a growing trend,this trend reminds us that along with the extensive use of antibiotics clinically,make the hospital infection rateshowed a trend of rising. During 2008-2011, the trend is rising, while in 2012, it start to decline. This may be related to our hospital carry out the Reasonable application of antibiotics strictly in recent years.