2004—2008年濮阳市血流感染革兰阴性菌耐药性分析  

DRUG RESISTANCE OF GRAM-NEGATIVE BACTERIA OF BLOODSTREAM INFECTION IN PUYANG CITY DURING 2004-2008

作　　者：颜秉兴[1] 李青鞠[1] 马卫红[1] 姜蕾[1] 

机构地区：[1]河南省濮阳市油田总医院检验科,457001

出　　处：《中国煤炭工业医学杂志》2010年第8期1094-1096,共3页Chinese Journal of Coal Industry Medicine

摘　　要：目的了解濮阳市血流感染革兰阴性菌的分布及主要病原菌对抗生素的耐药情况。方法血培养为梅里埃BacT/Alert3D系统,鉴定菌株采用Vitek2 compact,药敏试验采用微量肉汤稀释法。结果血流感染总阳性率为12.5%。革兰阴性杆菌占阳性标本的43.2%,以大肠埃希菌、肺炎克雷伯菌居多,分别占48.6%、30.0%。大肠埃希菌、肺炎克雷伯菌ESBL的检出率分别为40.8%、43.2%。大肠埃希菌、肺炎克雷伯菌、肠杆菌属AmpC酶检出率分别为2.0%、3.6%、36.7%,对IPM、TZP敏感率分别>96.7%和83.3%,对PIP、TET的耐药率超过82.9%。铜绿假单胞菌对PIP、CTX、CAZ、GEN的耐药率在31%～50%,对TZP、IPM、CIP的敏感率超过90.9%。结论本地区引起血流感染的革兰阴性菌主要为大肠埃希菌,其次肺炎克雷伯菌。所有主要病原菌特别是肠杆菌属菌株对常用抗生素的耐药现象比较严重。Objective To investigate the distribution and antibiotic resistance of the major gram-negative pathogens isolated from bloodstream infection in Puyang city. Methods Blood samples were cultured by BacT/Alert 3D of bioMérieux,Identification of bacteria was conducted with Vitek 2 compact ,antimicrobial sensitivity of clinical isolates was tested by broth microdilution method. Results The general positive rate of bloodstream infection was 12.5%. The gram-negative bacteria was 43.2% of positive samples. E. coli and K. pneumonia were the most frequently isolated,were 48.6% and 30.0% of the gram-negative bacteria,respectively. The positive rates of E.coli and K. pneumonia that produce ESBL were 40.8%and 43.2%,respectively. The rates of producing AmpC β-Lactamase of E. coli ,K pneumoniae ,Enterobacter isolates were 2.0%,3.6% ,36.7%,respectively. The sensitivity rates of E. coli,K pneumoniae and Enterobacter to IPM and TZP were more than 96.7%and 83.3%,respectively; the resistance rates to PIP and TET was more than 82.9%. The resistance rates of P. aeruginosa to PIP,CTX,CAZ,GEN was between 31% to 50%. The sensitivity rates of P. aeruginosa to TZP、IPM、CIP were more than 90.9%. Conclusion The main pathogens causing bloodstream infection in this area are E. coli,and K. pneumoniae fellows. The situation of antibiotic resistance to the commonly used antibiotics is serious in the main pathogens,particularly the Enterobacter.

关 键 词：血流感染 最小抑菌浓度 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]