马鞍山市某医院2009～2010年随机月份革兰阴性菌耐药性分析  

Analysis of the antimicrobial resistance of gram-negative bacteria in a hospital in Ma'anshan city from 2009 to 2010

作　　者：邓旭平 余路 程君 李家斌 

机构地区：[1]马鞍山市第四人民医院,243000

出　　处：《安徽医学》2012年第10期1272-1275,共4页Anhui Medical Journal

基　　金：国家自然科学基金(81071394);安徽省教育厅基金(KJ2010A344)

摘　　要：目的了解临床分离的革兰阴性菌对常用抗菌药物的耐药情况。方法对2009年及2010年马鞍山市细菌耐药监测资料中革兰阴性菌(包括大肠埃希菌、克雷伯杆菌属、铜绿假单胞菌、不动杆菌属)临床分离株选取其随机相同月份的菌株,对其耐药性情况进行分析。细菌药敏采用琼脂稀释法,并按2010年美国临床实验标准委员会(CLSI)指导原则的标准计算细菌对抗菌药物的敏感率(S)、中介率(I)和耐药率(R)。结果 2年革兰阴性菌分布由高到低均依次为大肠埃希菌、克雷伯菌属、铜绿假单胞菌及不动杆菌属,2年分类无明显差异。2年革兰阴性菌对β-内酰胺类抗菌药物敏感度未发生较大变化,2010年革兰阴性菌对喹诺酮类抗菌药物的敏感度较前有所下降,但对部分头孢菌素类抗菌药物的敏感度有所提升。2年不动杆菌属菌株对碳青霉烯类抗菌药物的敏感度低于其他革兰阴性菌。结论马鞍山地区引起临床疾病的革兰阴性菌中大肠埃希菌和克雷伯菌属仍占主要地位,铜绿假单胞菌和不动杆菌属略少。2010年与2009年相比革兰阴性菌对一些抗菌药物的敏感性已经发生变化,需根据药敏试验调整临床用药。Objective To analyze the clinical isolates of gram-negative bacteria resistance to antimicrobial agents. Methods Agar diffusion test was used to analyze the changes of drug susceptibility of gram-negative bacteria （including Eschericbia coli, Klebsiella spp., Pseudomonas aeruginosa, Acinetobacter） collected from a hospital in Ma＇anshan city from 2009 to 2010. The resistant rate （R%）, intermediate rate （1%） and susceptibility rate （S%） of drugs were calculated according to the criteria in guidelines of CLSI （2010）. Results The distri- bution of gram-negative bacteria in the two years was Escherichia coli, as followed by Klebsiella spp., Pseudomonas aeruginosa and Acineto- bacter. No significant difference was found between two classifications. The sensitivity of beta-lactams to gram-negative bacteria was not changed greatly from 2009 to 2010. In comparison with 2009, the sensitivity of quinolones to gram-negative bacteria was decreased in 2010, but cephalosporins was improved partly. The sensitivity of Acinetobacter to Carbapenems in two years maintained low level. Conclusion Es- cherichia coli and Klebsiella spp. are still the primary pathogens for the clinical disease caused by gram-negative bacteria, and Pseudomonas aeruginosa and Acinetobacter are the secondary; gram-negative bacteria on some antimicrobial sensitivity from 2009 to 2010 has changed, so that the clinical application of antibiotics should be adjusted.

关 键 词：革兰阴性菌 抗菌药物 细菌耐药性监测 

分 类 号：R446.5[医药卫生—诊断学]