重症监护病房常见革兰阴性杆菌耐药性分析及变化趋势

目的:了解青岛市市立医院重症监护病房(ICU)革兰阴性杆菌的分布及其耐药性,并了解其耐药性变化趋势。方法:收集来自重症监护病房各类标本分离的革兰阴性杆菌792株用V ITEK AMS260分析仪进行菌种鉴定,用K2B法进行药敏试验。结果:ICU检出的革兰阴性杆菌以鲍曼不动杆菌、铜绿假单胞菌、大肠埃希氏菌和肺炎克雷伯菌主,2012年与2011年相比,哌拉西林/他唑巴坦、头孢哌酮/舒巴坦敏感率下降明显,且有统计学意义(P<0.05);亚胺培南、美洛培南对大肠埃希氏菌、肺炎克雷伯菌仍保持着较高的敏感率,但对鲍曼不动杆菌、铜绿假单胞菌的敏感率下降明显,且有统计学意义(P<0.05)。结论:该院ICU检出的革兰阴性杆菌以鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌和肺炎克雷伯菌为主,且呈现多重耐药性,细菌耐药情况呈进一步恶化的趋势:

The objective of the research is to investigate the bacterial spectrum and antimicrobial resistance of gram-negative bacillus in 1CU, Qingdao Municipal Hospital. Methods： 1.to collect 792 granl-negative bacillus isolated from various specimens.2.to conduct strain identification with V ITEK AMS260 analyzer.3, to conduct drug susceptibility test with the K2B method. Results： main gram-negative bacillus in ICU include acinetobacter baumannii, pseudomonas aeruginosa, E. coli, and K. pneumoniae. Compared with the result in 2011, in 2012 , The sensitive rate of Piperacillin/Tazobactam and Cefoperazone / Sulbactam becomes significantly lower （P〈0.05）. Mmipenem and Meropenem remain significantly sensitive to E. coli, and K. pneumoniae, but significantly insensitive to acinetobacter baumarmii and pseudomonas aeruginosa （P〈0.05）. Conclusion： the gram-negative bacillus in the ICU mainly include acinetobacter baumannii, pseudomonas aeruginosa, E. coli, and K. pneumoniae. Multiple antimicrobial resistance is exhibited, and the situation of antimicrobial resistance is becoming worse.