阴沟肠杆菌临床分离与耐药性的6年监测  

Isolation and drug resistance of Enterobacter cloacae in hospital: A six years surveillance study

作　　者：王素梅[1] 吕火祥[1] 胡庆丰[1] 刘建栋[1] 

机构地区：[1]浙江省人民医院检验科,浙江杭州310014

出　　处：《中国微生态学杂志》2007年第2期196-197,199,共3页Chinese Journal of Microecology

摘　　要：目的了解2000年至2005年阴沟肠杆菌在临床标本中的分离情况及其耐药趋势，为临床感染的预防和治疗提供参考资料。方法回顾分析2000年至2005年间所有标本中阴沟肠杆菌的分离率，菌株在标本和病区的分布及对13种抗菌药物的耐药率。结果阴沟肠杆菌的分离率有逐年升高的趋势，从2000年的0．47％增至2005的0．69％；其在呼吸道标本的分离率最高（67．80％），其次是尿液（14．39％）、血液（9．28％）；病区以重症监护室最高（29．92％），阴沟肠杆菌对13种抗菌药物的耐药率，2000年仅氨苄西林、妥布霉素、庆大霉素〉50％，而到2005年13种抗菌药物除亚胺培南外的耐药率均〉50％；其耐药率均呈递增的趋势，以2003年的耐药率最高。耐药率增幅列前3位分别为：头孢他啶33．8％～72．8％、氨曲南41．9％～80．2％、哌拉西彬他唑巴坦48．4％～81．5％。结论阴沟肠杆菌的临床分离率在逐年增加，对多数抗菌药物有较高的耐药性，且耐药率呈整体上升趋势，尤其出现耐亚胺培南的耐药株，应引起重视，合理使用抗菌药物以降低耐药性已经非常重要。Objective To study the isolation and drug resistance tendency of Enterobaeter cloacae to antimicrobial agents from 2000 to 2005 and to provide avaluable data for infection prevention and therapy. Methods We reviewed the isolation rates, distribution in clinical specimens and wards, and the resistance rates of E. cloaeae to 13 kinds of antimicrobial agents from 2000 to 2005. Results There was an increasing tendency of isolation rates of E. cloacae year by year, which was 0.47% in 2000 but 0.69% in 2005. In the six years, there was the highest isolation rate of 67.8% in specimens from respiratory tract, the next was from the urine（ 14.39% ）, and blood（9.28% ）. Concerning the wards distribution, ICU was the highest rate of 29.92%. In 2000, E. cloacae had resistance rates more than 50%, and only to three kinds of antimicrobial agents （ampicillin, tobramycin, gentamycin）, but in 2005, it had increased to twelve kinds （except imipenem）. About the twelve kinds of antimicrobial agents （ except imipenem） were inspected , that were increased in their resistance rate. The highest increasing of resistance rate was ceftazidime from 33.8% in 2000 to 72.8% in 2003, the aztreonam was second for 41.9% to 80.2%, and the third was piperacillin/tazobactam from 48.4% to 81.5%. Conclusions The clinical isolation rate of E. cloaeae is increasing, and it has higher resistance rates than ever year. More attention should be paid to isolate resistant to imipenem. So physicians should prescribe on the baisis of antimicrobial agents susceptibility tests in vivo.

关 键 词：阴沟肠杆菌 分离率 耐药率 

分 类 号：R378.22[医药卫生—病原生物学]