革兰阴性菌的分布与耐药性分析

Distribution and drug resistance of gram-negative bacteria

目的了解医院3年革兰阴性菌分布及耐药变迁并提供有效数据,指导临床合理应用抗菌药物。方法回顾性分析东南大学附属中大医院2009年1月-2011年12月临床标本分离的革兰阴性菌的分布和耐药性变迁。结果 3年共分离革兰阴性菌4197株,主要为鲍氏不动杆菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌,分别占21.3%、21.0%、18.6%、11.1%;鲍氏不动杆菌对常用抗菌药物耐药率较高>60.0%;大肠埃希菌、肺炎克雷伯菌对碳青霉烯类抗菌药物耐药率低<3.0%,对其他抗菌药物耐药率高>50.0%;铜绿假单胞菌对头孢唑林、头孢曲松、呋喃妥因、磺胺甲噁唑/甲氧苄啶耐药>97.5%。结论医院3年革兰阴性菌的检出率有上升趋势,主要革兰阴性菌的耐药率有下降趋势,应加强耐药性监测,合理使用抗菌药物。

OBJECTIVE To investigate the distribution and drug resistance of gram-negauve bacteria lsolated in the past three years so as to guide the reasonable clinical use of antibiotics. METHODS The gram-negative bacteria which were isolated from the clinical specimens obtained from Zhongda Hospital Affiliated Southeast University from Jan 2009 to Dec 2011 were collected, then the distribution and change of drug resistance were retrospectively analyzed. RESULTS Totally 4197 strains of gram-negative bacteria have been isolated in the past three years, among which the Acinetobacter baurnanii , Escherichia coli , Klebsiella pneumoniae , and Pseudornonas aeruginosa were dominant, accounting for 21.3%, 21.0%, 18. 6%, and 11.1%, respectively. The A. baumannii strains were highly resistant to the commonly used antibiotics, with the drug resistance rate more than 60.0% the drug resistance rate of the E. coli and K. pneurnoniae strains to carbapenems were less than 3. 0%, with the drug resistance rates more than 50.0% to most antibiotics; P. aeruginosa strains were highly resistant to cefazolin, ceftriaxone, nitrofurantoin, and sulfamethoxazole-trimethoprim, with the drug resistance rate more than 97.5 %. CONCLUSION The detection rate of the gram-negative bacteria shows an upward trend during the past three years; the drug resistance rates of the main gram-negative bacteria show a downward trend; it is necessary to intensify the surveillance of drug resistance and reasonably use antibiotics.