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中医院革兰阴性杆菌的临床分布与耐药分析 被引量:5

Distribution and antibiotic resistance of gram negative bacilli in a hospital of traditional Chinese medicine
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摘要 目的了解2013年度中医院分离革兰阴性杆菌的临床分布及耐药现状,指导临床医师合理用药。方法对2013年1—12月培养分离的革兰阴性杆菌及其耐药性进行统计分析。结果 2013年医院分离革兰阴性杆菌共1 401株,居首位的是大肠埃希菌381株,占27.2%;余依次为肺炎克雷伯菌311株,占22.2%;铜绿假单胞菌249株,占17.8%;鲍曼不动杆菌194株,占13.8%;肠杆菌属114株,占8.1%。革兰阴性杆菌对亚胺培南、阿米卡星、含β内酰胺酶抑制剂的复合制剂耐药率相对较低;对头孢菌素、庆大霉素、环丙沙星的耐药率相对高。未检出耐亚胺培南的肠杆菌科细菌。该研究中大肠埃希菌超广谱β内酰胺酶(ESBL)检出率为45.4%,肺炎克雷伯菌ESBL检出率为42.1%;产ESBL的大肠埃希菌、肺炎克雷伯菌及鲍曼不动杆菌多表现为多重耐药。结论了解中医院革兰阴性杆菌的临床分布及耐药特点,指导临床医师根据药敏结果合理使用抗菌药物非常重要。 Objective To investigate the distribution and antibiotic resistance of gram-negative bacilli isolated from a hospital of traditional Chinese medicine during 2013 for better use of antimicrobial agents. Methods The gram-negative bacilli isolated during 2013 and their susceptibility testing data were analyzed. Results A total of 1 401 strains of gram negative bacilli were collected. The most frequently isolated species was E. coli (27. 2G, 38l/1 401 ), followed by K. pneumoniae (22. 2%, 311/ 1 401), Pseudomonas spp. (17. 8%, 249/1 401 ), Acinetobacter spp. (13. 8%, 194/1 401 ), and Enterobacter spp. (8. 1%, 114/1 401). The gram-negative bacilli strains were less resistant to imipenem, amikacin, and beta-lactam/beta-lactamase inhibitor combination, but more resistant to cephalosporins, gentamicin, and ciprofloxacin. No Enterobacteriaceae isolate was found resistant to imipenem. Extended-spectrum beta-lactamases (ESBLs) were positive in 45. 4% of E. coli isolates and 42. 1% of K. pneumoniae isolates. ESBLs-produeing E. coli, K. pneumoniae and Acinetobacter strains were mostly resistant to multiple antimicrobial agents. Conclusions It is necessary for clinicians to understand the information of distribution and resistant pattern of gram-negative bacilli in their hospital for rational use of antimicrobial agents.
出处 《中国感染与化疗杂志》 CAS CSCD 北大核心 2015年第4期359-363,共5页 Chinese Journal of Infection and Chemotherapy
关键词 医院感染 革兰阴性杆菌 耐药性 nosocomial infection gram negative bacillus antibiotic resistance
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