ICU与非ICU肠杆菌科细菌的耐药性分析

Drug resistance of ICU and non-ICU Enterobacteriaceae isolates

目的了解临床肠杆菌科细菌感染的药敏变化,比较ICU与非ICU肠杆菌科细菌的耐药性,为临床合理应用抗菌药物提供科学依据。方法对2010年6月-2013年9月临床各类标本中分离出的产肠杆菌科细菌1 661株,其中ICU 259株与非ICU1 402株进行比较分析,采用VITEK-32微生物分析系统进行病原菌鉴定,药敏试验采用K-B纸片法,应用SPSS 19.0软件对临床分离细菌的药敏试验结果进行统计分析。结果 ICU、非ICU肠杆菌科细菌对头孢唑林、氨曲南、妥布霉素、奈替米星、氯霉素的耐药率分别为85.71%、67.4%,49.03%、32.67%,49.03%、41.08%,35.52%、23.75%,54.44%、34.74%,ICU耐药率明显高于非ICU,差异有统计学意义(P<0.05)。结论 ICU肠杆菌科细菌耐药率远较非ICU严重,在临床选用抗菌药物治疗肠杆菌科细菌感染时要根据当地细菌的耐药特点,合理选用抗菌药物,防止肠杆菌科细菌尤其是多药耐药菌的传播与感染。

OBJECTIVE To investigate the change of drug susceptibility of the clinical Enterobacteriaceae isolates causing infections and compare the drug resistance between the ICU and non‐ICU Enterobacteriaceae isolates so as to provide scientific basis for reasonable clinical use of antibiotics .METHODS A total of 1 661 strains of Enterobac‐teriaceae were isolated from the clinical specimens from Jun 2010 to Sep 2013 ,including 259 ICU strains and 1402 non‐ICU strains ;the pathogens were identified by using VITEK‐32 microorganism analysis system ,the drug sus‐ceptibility testing was performed by means of K‐B disk method ,and the results of the drug susceptibility testing for the clinical isolates were statistically analyzed with the use of SPSS19 .0 software .RESULTS The drug resist‐ance rates of the ICU and non‐ICU Enterobacteriaceae strains to cefazolin ,aztreonam ,tobramycin ,netilmicin ,and chloramphenicol were respectively 85 .71% ,49 .03% ,49 .03% ,35 .52% ,and 54 .44% ,significantly higher than 67 .4% ,32 .67% ,41 .08% ,23 .75% ,and 34 .74% of the non‐ICU strains （P〈0 .05） .CONCLUSION The drug resistance rate of the ICU Enterobacteriaceae isolates is significantly higher than that of the non‐ICU strains ,and it is necessary for the hospital to reasonably use antibiotics on the basis of the characteristics of local Enterobacte‐riaceae isolates causing infections so as to prevent the spread and infections of the Enterobacteriaceae ,especially the multidrug‐resistant strains .