2006年～2009年临床分离常见革兰阴性杆菌的耐药性动态分析  

Bacterial resistance surveillance analysis of common Gram-negative Bacilli clinical isolates from 2006 to 2009

作　　者：衣美英[1] 王立伟[1] 王靖[1] 佟小萌[1] 张磊[1] 贾红兵[1] 李杰[1] 李春英[1] 张月娴[1] 鄢盛恺[1] 

机构地区：[1]中日友好医院检验科,北京100029

出　　处：《中日友好医院学报》2010年第5期271-274,285,共5页Journal of China-Japan Friendship Hospital

基　　金：中日友好医院院级课题(编号:2010-MS-54)

摘　　要：目的:连续监测2006年～2009年临床分离常见革兰氏阴性杆菌对抗菌药物的耐药性,以指导临床合理用药。方法:用VITEK-II全自动微生物分析仪和常规方法对临床分离菌株进行鉴定和药敏试验,用WHONET-5.4软件对数据进行分析。结果:医院4年从各种临床标本共分离4818株非重复革兰阴性杆菌,大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌等为主要分离菌。大部分菌株对氨基糖苷类药物阿米卡星敏感;对三代、四代头孢菌素类和氨曲南类抗菌药物耐药率呈上升趋势;对含酶抑制剂的药物比不加酶抑制剂药物的耐药率明显下降;碳青霉烯类抗菌药物仍然保持高效、广谱的抗菌活性,但其敏感性也逐年降低。大肠埃希菌、肺炎克雷伯菌ESBL检出率连续4年呈上升趋势,产超广谱β-内酰胺酶(ESBL)菌株对抗菌药物敏感率普遍低于非产ESBL菌株。结论:动态了解常见革兰阴性杆菌对抗菌药物耐药性变迁情况,有助于指导临床合理用药。Objective：To investigate the antimicrobial resistance of common Gram-negative Bacilli clinical isolates collected in the hospital from 2006 to 2009.Methods：All strains collected were identified and the antimicrobial susceptibility were determined with VITEK-2.The data were analyzed by WHONET5.4 software.Results：From 2006 to 2009,4818 consecutive and non-repetitive Gram-negative Bacilli were collected from the hospital.Most common isolates were Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae,Acinetobacter baumannii,et al.Most strains were sensitive to amikacin.There was an elevated tendency of resistance rates to the third,the fourth generation cephalosporins and aztreonam.Piperacillin/tazobatam was more powerful than piperacillin.Gram-negative Bacilli were sensitive to imipenem and meropenem.But the resistence rate was increasing.The incidence of extended spectrum β-lactamases producing strains of Escherichia coli,Klebsiella pneumoniae was increasing.Conclusion：Investigating the drug resistance evolution of Gram-negative bacillus dynamically will be useful for rational medication and improvement of cure rate.

关 键 词：革兰阴性杆菌 抗菌药物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]