佳木斯地区耐碳青霉烯类革兰阴性杆菌分布及耐药性分析

Distribution and antimicrobial resistance of carbapenem-resistant gram-negative bacilli in Jiamusi

目的调查佳木斯大学附属第一医院耐碳青霉烯类革兰阴性杆菌临床分布特点,及对常用抗菌药物的敏感性和耐药性。方法分析2015年1月-2017年1月医院临床分离的耐碳青霉烯类革兰阴性杆菌分布特点和药敏结果。药敏试验采用自动化仪器法或K-B纸片扩散法。结果 310株耐碳青霉烯类革兰阴性杆菌中,居首位的是鲍曼不动杆菌,占67.4%。药敏试验结果显示分离菌株耐药率高,仅对多黏菌素B的敏感率均>90%,全部鲍曼不动杆菌和肺炎克雷伯菌以及87%铜绿假单胞菌为多药耐药菌株,鲍曼不动杆菌耐药性最强,对环丙沙星、头孢菌素类、加酶抑制剂青霉素类和头孢替坦的耐药率>90%,对多黏菌素以外的药物敏感率<20%。结论本地区耐碳青酶烯类革兰阴性杆菌临床分布比较集中,对常用抗菌药物呈高度耐药,提示临床应加强细菌耐药性监测,合理有效使用抗菌药物。

Objective To investigate the distribution characteristics and antimicrobial resistance of carbapenem-resistant gram-negative bacilli isolated from clinical samples in The First Affiliated Hospital of Jiamusi University. Methods Carbapenem-resistant gram-negative bacilli were collected from patients in a general hospital in Jiamusi during January 2015-January2017 for the distribution characteristics and detection results analysis. Antimicrobial susceptibility testing was carried out according to K-B method or automated systems. Results Of 310 strains of carbapenem-resistant gram-negatibe bacilli,the most frequently isolated species was Acinetobacter baumannii（ 67. 4%）. Antimicrobial susceptibility testing showed that the resistance rates of the isolates was high,and its susceptibility rate was more than 90% to Polymyxin B. All Acinetobacter baumannii,Klebsiella pneumoniae and 87% Pseudomonas aeruginosa were multi-drug resistant strains. The resistance of Acinetobacter baumannii was the strongest,and the resistance rates to ciprofloxacin,cephalosporins,enzyme inhibitors,penicillins and cephalosporins were all more than 90%,while that to polymyxin was less than 20%. Conclusion The carbapenem-resistant gram-negative bacilli in Jiamusi show a concentrated distribution and a highly resistance to the commonly used antibiotics. Clinics should strengthen the antimicrobial resistance surveillance and use antibiotics rationally.