阴沟肠杆菌临床分布与耐药性分析

Clinical distribution and antimicrobial resistance of Enterobacter cloacae

目的了解医院分离阴沟肠杆菌的临床分布及其耐药性,为临床合理使用抗菌药物提供参考依据。方法收集2008-2013年临床分离的阴沟肠杆菌,采用纸片扩散法(K-B法)进行常用抗菌药物的药敏试验,结果用WHONET 5.6软件进行统计分析。结果 2008-2013年从临床各类标本中共分离出418株阴沟肠杆菌,其中住院患者检出415株,占99.2%;科室分布占前3位的依次为骨科、呼吸科、泌尿外科,分别占23.2%、12.2%、9.3%;标本分布以创伤口、痰液、尿液最多见,分别占37.6%、34.0%、15.6%;阴沟肠杆菌对亚胺培南敏感率为100.0%,磺胺类药物敏感率由70.3%下降至32.8%。结论阴沟肠杆菌主要引起创伤口、呼吸道以及尿路的临床感染,阴沟肠杆菌对阿米卡星、头孢吡肟敏感性较高,阴沟肠杆菌对磺胺类抗菌药物敏感性有下降趋势,可作为重症患者首选治疗药物。

OBJECTIVE To investigate the clinical distribution and antimicrobial resistance of Enterobacter cloacae （E .cloacae） isolated from our hospital in recent years ,so as to provide the basis for rational use of antimicrobial drugs .METHODS Clinical isolates of E .cloacae in our hospital from 2008 to 2013 were collected .Antimicrobial susceptibility testing of 23 kinds of common clinical antibiotics was conducted using Kirby‐Bauer （K‐B） method . The data were statistically analyzed by WHONET 5 .6 software .RESULTS A total of 418 strains of E .cloacae were collected from a variety of clinical specimens from 2008 to 2013 ,among which 415 strains were detected from hospitalized patients ,accounting for 99 .2% .According to department ,the percentages of these strains isolated from orthopedic ,respiratory and urological department ranked the top three ,respectively being 23 .2% ,12 .2% , and 9 .3% .According to specimens ,these strains isolated from wound ,sputum and urine were the most common , accounting for 37 .6% ,34 .0% ,and 15 .6% .The drug‐resistance rate to imipenem was 100% ,and the resistance rate to sulfonamides was decreased from the highest 70 .3% to the lowest 32 .8% .CONCLUSION E . cloacae mainly causes clinical infections of wound ,respiratory tract and urinary tract .Its drug resistance rates to amikacin and cefepime are higher ,while its drug‐resistance rates to sulfonamides show a downward trend and sulfonamides remain to be the best choice to treat the severe infection caused by E .cloacae .