2007-2010年医院分离细菌的耐药性分析  

Analysis of antibiotic resistance of clinical isolated bacterial from 2007 to 2010

作　　者：张晋会[1] 申瑞翔[1] 牛俊杰[1] 

机构地区：[1]山西省晋城煤业集团总医院检验科,山西晋城048006

出　　处：《中华医院感染学杂志》2012年第1期179-181,共3页Chinese Journal of Nosocomiology

摘　　要：目的分析2007年1月1日-2010年12月31日医院临床分离细菌中主要细菌的分布及耐药性,为临床抗感染治疗提供依据。方法对医院从患者标本中分离出的主要病原菌,采用法国生物梅里埃公司的VITEK-2Compact进行细菌鉴定及药物敏感试验,对细菌的分布及耐药率进行回顾性统计分析。结果 4年临床共分离出非重复的细菌1977株,其中革兰阴性菌占72.4%,革兰阳性菌占27.6%;肠杆菌科细菌对碳青霉烯类抗菌药物、阿米卡星和哌拉西林/他唑巴坦的耐药率均较低,对三、四代头孢类抗菌药物的耐药率逐年上升,大肠埃希菌产ESBLs菌株检出率呈逐年上升趋势,非发酵菌中铜绿假单胞菌对所测试抗菌药物的耐药率大多<30.0%;鲍氏不动杆菌的分离率和耐药率呈逐年上升趋势;革兰阳性菌不同菌种的耐药谱明显不同,未发现对万古霉素、替考拉宁耐药的菌株。结论应加强对大肠埃希菌和鲍氏不动杆菌的耐药性监测,合理使用抗菌药物,遏制细菌耐药性的进一步蔓延。OBJECTIVE To analyze the distribution and drug resistance of main bacteria isolated from clinical practice from Jan. 1st 2007 to Dec. 31st 2010, so as to provide evidence for clinical anti-infection treatment. METHODS The main strains were isolated from patient specimens; the bacterial identification and drug susceptibility testing were performed by using Merieux Alliance VITEK 2-Compact in French. The distribution of bacteria and their drug resistance were retrospectively analyzed. RESULTS A total of 1977 strains were isolated non-repetitive in clinical practice during the past four years, which included 72.4% of Gram-negative bacteria and 27. 6% of Gram-positive bacteria. The resistance rates to carbapenems antibacterial agents, amikacin and piperacillin/tazobactam of Enterbacteriaceae were still lower, but increased year after year to the third-generation cephalosporin and the fourth-generation cephalosporin. The rate of Escherichia. coli strains producing extended spectrum beta-lactamase （ESBLs） has been increasing. Resistance rates of Pseudomonas aeruginosa in Non- fermenting bacteria to most tested drugs were lower than 30.0%. The isolation rate and the resistant rate of Acinetobacter baumannii to antibacterial agents were increased year after year. The drug resistant spectrums of Grampositive bacteria were significantly different. No strains resistant to vancomycin and teicoplanin were found. CONCLUSION It is important to further enhance the surveillance of drug resistance of E. coli and A. baumannii, and reasonable use of antibiotics is important for the containment of further spread of drug resistance.

关 键 词：耐药性 肠杆菌科 非发酵菌 革兰阳性菌 分析 

分 类 号：R378[医药卫生—病原生物学]