摘要
目的:了解我院住院患者分离的革兰阴性菌分布、耐药情况,为临床合理用药提供依据。方法:回顾性分析我院2013—2014年临床分离的革兰阴性菌,进行鉴定和药敏试验,分析其耐药率及耐药变化。结果:2013—2014年期间共分离细菌2030株,其中革兰阴性菌占74.7%,革兰阳性菌占25.3%。革兰阴性菌主要分离株依次为大肠埃希菌514株、铜绿假单胞菌364株、肺炎克雷伯菌240株、鲍曼不动杆菌210株,其他阴性菌250株。肠杆菌科细菌产ESBLs的检出率分别为大肠埃希菌65%,肺炎克雷伯菌36%;铜绿假单胞菌对常见抗菌药物的耐药率多在30%以下,但对亚胺培南、关洛培南的耐药率均在30%以上;鲍曼不动杆菌对多种常用抗菌药物高度耐药,耐药率多在50%以上,有些甚至超过了90%。结论:革兰阴性杆菌在我院的流行情况非常严重,需加强抗感染管理及院内流行株得监测。并根据药敏试验结果结合临床合理用药,减少滥用抗生素带来细菌耐药率的升高。
Objective : To analyze the distribution and the drug resistance of gram-negative bacteria isolated in inpatient in our hospital for guiding rational drug use. Methods : Retrospective analysis of the gram-negative bacteria isolated during 2013-2014 in our hospital ,perform identification and drug sensitive test to analyze the drug resistance rates and changing tendency.Results : Totally 2030 bacterial strains were isolated during the period of 2013-2014 , 74.7% of which were gram-negative bacteria and 25.3% were gram-positive bacteria.The main gram-negative bacteria isolated were Escherichia coli ( 514 strains ) , Pseudomonas aeruginosa ( 364 strains ), Klebsiella pneumoniae ( 240 strains ), Acinetobacter baumannii ( 210 strains ) and other gram-negative bacteria (250 strains).The detection rates of ESBLs in Escherichia coli and KlebsieUa pneumoniae were 65% and 36% respectively. The drug resistance rates ofPseudomonas aeruginosa to most common antibiotics were under 30%. Both lmipenem and Meropenem were above 30%; Acinetobacter baumannii is highly resistant to many kinds of common antibiotics, which resistance rates were more than 50%, some even more than 90%. Conclusions : The prevalence of gram-negative bacteria in our hospital is very serious.The findings suggest that it is urgent to practice stringent management system for antibiotic use and close supervision over gram-negative bacteria, and infection control inventions shall be on rational basis of drug sensitivity test.
出处
《医学检验与临床》
2015年第6期37-40,共4页
Medical Laboratory Science and Clinics
关键词
耐药
耐药率
革兰阴性菌
Drug resistance
Drug resistance rates
Gram-negative bacteria