我院1999～2001年革兰氏阴性杆菌分布及耐药性变迁分析

Distribution and resistant profile analyses of Gram-negative bacilli in our hospital,1999～2001

目的了解革兰氏阴性杆菌的流行分布及耐药谱的变化,为临床合理选用抗生素提供依据。方法对我院1999～2001三年间革兰氏阴性杆菌耐药性变迁进行回顾性统计分析。结果革兰氏阴性杆菌三年检出率分别为64.3%、58.7%、53.7%;克雷伯氏菌对头孢噻肟的耐药率增长了13.8%,大肠埃希氏菌对环丙沙星的耐药率增长了13.6%,铜绿假单胞菌对亚胺培南耐药率增长了8.4%,阿米卡星耐药率变化不大;产ESBLs的大肠埃希氏菌和克雷伯氏菌分别从21.5%、20.2%上升至28.8%、31.7%。结论三年间临床分离致病菌都以革兰氏阴性杆菌为主,但检出率有逐年下降趋势;肠杆菌科细菌比例下降,不动杆菌属和嗜麦芽寡养单胞菌比例增加;抗生素的耐药性普遍增加;ESBLs检出率明显增加。

Objective To analyze the distribution and resistant profile of Gra m-negative bacilli against various antibiotics in our hospital. Methods The r esistant patterns were analyzed by a retrospective analysis from the year 1999～ 2001.Results The detection rate of Gram-negative bacilli was 64.3% ,58.7% and 53.7% respectively.The resistance rates of various bacilli against differe nt antibiotics were as follows:Klebisella spp. against cefotaxime increased 13.8 % ;E.coli against ciprofloxacin increased 13.6% ;Pseudomonas aeruginosa agaist impinem increased 8.4% , while against amikacin was not significantly increas ed;as for ESBL-producing E.coli and Klebisella spp. The detection rates were 2 1.5% ,25.2% ,28.8% and 20.2% , 26.7% , 31.7% respectively.Conclusions I n the three year period,the Gram-negative bacillus was the major bacteria isol ated, the detection rate was yearly decreased,as shown by Enterobacteriaceae ba cilli while Acinetobacter and P.maltophila were increased.Particularly,the antib iotics resistance rate was significantly increased to the those of ESBL-produc ing strains.