近三年产气肠杆菌临床感染情况分析

The antibiotic-resistance of Enterobacter aerogenes in past three years

目的监测嵊州市人民医院近三年产气肠杆菌对常用抗生素耐药情况。方法对嵊州市人民医院2013年至2015年间收集的产气肠杆菌临床科室分布情况进行统计,并做临床常用抗生素耐药性分析,用WHONET 5.4软件进行统计学分析。结果分离得到的产气肠杆菌主要来源于神经外科、重症医学科和呼吸内科的痰液和尿液标本。药敏结果显示其对第一、二代头孢类抗生素耐药率普遍较高:对头孢唑啉几乎全耐药,对头孢呋辛耐药率约为55%;第四代的头孢吡肟能明显抑制产气肠杆菌生长,2013年到2015年对头孢吡肟耐药率分别为8.18%、9.14%和10.74%;对氨基糖苷类抗生素庆大霉素和丁胺卡那,以及碳青霉烯类抗生素亚胺培南和美罗培南具有很高的敏感性。结论嵊州市人民医院院感科近年间通过对产气肠杆菌临床用药的合理监测,及时向临床医生反馈微生物实验室的耐药结果,避免了抗生素滥用,使得其对抗生素耐药率未出现明显提高。氨基糖苷类抗生素和碳青霉烯类抗生素对其仍具有很高的疗效,应继续通过药敏试验加强对其耐药性监测,指导临床合理用药。

Objective To investigate the clinical distribution and antibiotic-resistance of Enterobacter aerogenes in our hospital from 2013 to 2015.Methods Clinical specimens from each department were collected to analyze the distribution of Enterobacter aerogenes in our hospital.The drug susceptibility was detected with K-B method and statistical analysis was done with WHONET 5.4software.Results Most of the Enterobacter aerogenes strains were isolated from the specimens of sputa and urine of patients in departments of neurosurgery,respiratory medicine and ICUs.The resistance rate of those strains to cefazolin was almostly100%.The sensitivities of them to aminoglycoside antibiotics（gentamicin and kanamycin）and carbapenem antibiotics（imipenem and meropenem）were very high.Conclusion The resistance of Enterobacter aerogenes in our hospital did not change obviously in recent years.It is necessary to strengthen the monitoring of drug resistance through drug sensitivity test.