2008―2012年临床分离阴沟肠杆菌的分布及耐药性分析

Distribution and analysis of antibiotic resistance in Enterobacter cloacae isolates during year 2008—2012

目的了解我院2008年1月―2012年12月阴沟肠杆菌分离株的临床分布及耐药性特点,为临床合理选用抗菌药物提供参考依据。方法采用WHONET5.6软件回顾性分析5年内阴沟肠杆菌株的标本来源、感染科室分布及耐药状况。结果 5年内共分离出阴沟肠杆菌1068株,菌株来源以呼吸道标本、分泌物、尿液标本为主;临床感染主要分布于急诊外科、外科、内科、重症监护病房(ICU);药敏结果显示,5年内,阴沟肠杆菌对氨苄西林/舒巴坦的耐药率最高(>60.0%);对亚胺培南耐药率最低(<8.0%)。2009-2012年,除亚胺培南、氨苄西林/舒巴坦、复方磺胺甲噁唑、替卡西林/克拉维酸外,阴沟肠杆菌对其余11种抗生素的耐药率逐渐下降(P<0.05)。结论阴沟肠杆菌对临床常用抗菌药物的耐药率呈下降趋势;对于碳青霉烯类抗生素不敏感菌株的出现应引起重视。

Objective To comprehend the clinical distribution and drug resistance of E. cloacae isolated from Jan 2008 to Dec 2012 so as to provide basis for the clinical reasonable use of antibiotics. Methods The clinical data of drug resistance of our hospital on all of E. cloacae isolates during five years were analyzed retrospectively by using WHONET5.6 software. Results A total of 1,068 clinical strains of E.cloacae were isolated during five years, which mainly isolated from respiratory tract specimens, secretions and urine. The clinical distribution of E. cloacae strains mainly isolated from emergency surgery, surgery, internal medicine and intensive care unit （ICU）. The percentage of E. cloacae resistant to ampicillin/sulbactam was the highest（~ 60.0%）, and showed the lowest resistant rate to imipenem（~60.0%）. The drug resistance rates of E.cloacae have decreased from 2009 to 2012 （P^0.05）, except for imipenem, ampicillin/sulbactam, trimethoprim/sulfamethoxazole, ticarcillin/clavulanic acid. Conclusion The changes of resistance rates of E. cloacae to antimicrobials were decreased. The emergence of carbapenems-resistant of E. cloacae should be paid more attention.