不同临床标本分离的肠杆菌科细菌耐药率的差异

Comparative analysis of Enterobacteriaceae bacteria resistance between different clinical specimens

目的：对华西医院2009～2011年分离的肠杆菌科细菌进行分析，探讨标本类型对肠杆菌科耐药率的影响。方法采用VITEK Ⅱ Compact ，Walkaway 96 SI进行菌株鉴定和药敏试验，结果解释参照CLSI M100‐S22标准。结果共分离非重复肠杆菌科细菌12100株，主要包括埃希菌属（35．7％）、克雷伯菌属（33．9％）和肠杆菌属（18．4％）。痰标本占52％，非痰标本占48％。非痰标本菌株对除哌拉西林／他唑巴坦、头孢西丁和亚胺培南抗菌药物耐药性显著高于痰标本菌株（ P＜0．05）。结论非痰标本来源的菌株显示更强的耐药性。

Objective To investigate the antibiotic resistance of Enterobacteriaceae isolates collected from West China hospi‐tal in 2009-2011 and to study the impact of the specimen type on the antibiotic resistance and clinical diagnosis .Methods VITEKⅡCompact and Walkaway 96 SI were employed to identify bacterial isolated from different samples .The antimicrobial resistance were analyzed according to CLSI M100‐S22 standards .Results A total of 12 100 non‐duplicate Enterobacteriaceae isolates were collected ,including Escherichia（35 .7% ） ,Klebsiella spp （33 .9% ） ,Enterobacter（18 .4% ） .Of 52% samples were isolated from spu‐tum and 48% samples were non‐sputum .The antibiotic resistance rate of strains isolated from non‐sputum samples was significantly higher than strains from sputum specimens in antibiotics except TZP ,IPM and FOX（P〈0 .05） .The antibiotic resistance rate of Escherichia from sputum specimens was significantly higher than strains from non‐sputum specimens （except cefoxitin）（P〈0 .05） . Klebsiella and Enterobacter were opposite of Escherichia .Conclusion The strains isolated from sputum specimens were more re‐sistant to antibiotics ,Resistance strains were more likely caused infection in clinical than susceptibility strains .Escherichia isolates were more likely to cause infection in sputum than Klebsiella and Enterobacter isolates .