内科住院患者感染革兰阴性杆菌的分布及耐药分析

Distribution and drug resistance of gram-negative bacilli in inpatients of internal medicine

目的：了解我院内科系统住院患者感染革兰阴性杆菌的种类、分布及耐药情况，为临床合理用药提供依据。方法对2011年5月-2012年4月本院内科系统住院患者的各类标本分离的革兰阴性杆菌进行培养和药物敏感试验。结果共分离培养出195株革兰阴性杆菌，以大肠埃希菌、肺炎克雷伯杆菌、鲍曼不动杆菌、铜绿假单胞菌、阴沟肠杆菌为主。大多数革兰阴性杆菌对广谱青霉素、磺胺类、喹喏酮类和第三代头孢菌素明显耐药，其次是头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星和头孢吡肟，对碳青酶烯类最敏感。鲍曼不动杆菌普遍严重耐药。结论我院革兰阴性杆菌的耐药性日趋严重，加强对临床分离的主要病原菌进行耐药性监测，有利于抗菌药物的合理使用，减缓多重耐药菌株的出现。

Objective To investigate the species,distribution and drug resistance of gram-negative bacilli infected by the inpatients of internal medicine. Methods Culture and drug sensitive test were made to the gram-negative bacilli isolated from the specimens of patients hospitalized during the period from May,2011 to April,2012. Results In total,195 strains of gram-negative bacilli were isolated and the five major bacteria were escherichia coli,klebsiella pneumoniae,acinetobacter baumannii,pseudomonas＆amp;nbsp;aeruginosa and enterobacter cloacae;most gram-negative bacilli were highly resisted to broad-spectrum penicillin,sulfonamide, quinolones and the third-generation cephalosporins and then to cefoperazone sulbactam,piperacillin sulbactam,amikacin and cefepime;they had the strongest resistance to carbapenems;a general high resistance was found in acinetobacter baumannii. Conclusions It should be strengthen to monitor the drug resistance of the main pathogenic bacteria isolated from clinic,which is conducive to the rational use of antibiotics and can retard the emergence of strains with multi-resistance.