2012～2015年我院院内感染奇异变形杆菌的分布及耐药性变迁

Clinical distribution and change of drug resistance of Proteus mirabilis causing nosocomial infections in our hospital from 2012 to 2015

目的分析中国医科大学附属盛京医院(以下简称"我院")院内感染的奇异变形杆菌的分布及耐药性变迁,为临床合理应用抗生素提供参考依据。方法回顾性研究2012年1月1日~2015年12月31日我院奇异变形杆菌院内感染患者的临床数据,分析其临床分布及耐药情况。结果共检出266株奇异变形杆菌,标本主要来源于尿液(57.89%),其次为分泌物(9.02%)、引流液(7.89%)、痰液(7.89%)、脓汁(7.14%)、全血(3.76%)等。科室分布以泌尿外科奇异变形杆菌检出率最高(19.92%),其次为ICU(12.78%)和康复科(10.53%)。奇异变形杆菌对呋喃妥因、四环素的耐药率极高,均大于90.0%,对替卡西林/克拉维酸、厄他培南的耐药率4年均为0。对头孢唑啉的耐药率上升最显著,从54.55%上升至92.59%;对头孢他啶、头孢吡肟耐药率4年连续下降,分别从33.33%、36.11%降至3.70%、7.32%。结论 2012~2015年我院奇异变形杆菌的分离率呈增长趋势,提示随着临床上大量使用抗生素,医院的感染率亦上升。奇异变形杆菌对不同的抗生素耐药性不同,监测院内奇异变形杆菌的耐药性及其变迁对临床合理用药有重要指导作用。

Objective To analyze the clinical distribution and drug resistance of Proteus mirabilis causing nosocomial infections in Shengjing Hospital of China Medical University （＂our hospital＂ for short）, in order to provide evidence for choosing antibiotics reasonably. Methods The clinical distribution and drug resistance of Proteus mirabilis in hospital ized patients from 1 January 2012 to 31 December 2015 were studied retrospectively. Results A total of 266 strains were isolated. The specimens mainly isolated from urine （57.89%）, followed by secretion （9.02%）, drainage fluids （7.89%）, sputum （7.89%）, pus（7.14%） and blood（3.76%）. The specimens were mainly isolated from the Department of Urinary Surgery （19.92%）, followed by Intensive Care Unit （12.78%） and Department of Rehabilitation （10.53%）. The drug re- sistance rates of Proteus mirabilis to Furantoin, Tetracycline were 〉90%, to Ticarcillin/Clavulanic Acid, Ertapenem were lowest,both 0. The resistance rate of Proteus mirabilis to Cefazolin increased markedly, from 54.55% to 92.59%, to Cefiazidime and Cefepime decreased sharply, from 33.33%, 36.11% to 3.70% and 7.32%, respectively. Conclusion Proteus mirabilis separation rate from 2012 to 2015 is in a growing trend. This trend reminds that along with the exten- sive use of antibiotics clinically, the hospital infection rate showes a trend of rising. Proteus mirabilis has different drugresistance to different antimicrobial drugs tial for strengthening the management of . It is essen- antimicrobial abuse and monitoring results of antibiotic resistance