县级医院2010-2011年革兰阴性杆菌临床株耐药性监测  

Monitoring of drug-resistance of clinical isolates of GNB in county hospital from 2010 to 2011

作　　者：张才仕 赵甲[1] 秦声远 

机构地区：[1]监利县人民医院检验科,湖北监利433300

出　　处：《临床血液学杂志（输血与检验）》2012年第6期767-770,共4页Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)

摘　　要：目的:了解县级医院2010—2011年临床分离的革兰阴性杆菌对常用抗菌药物的耐药性,为临床医师合理用药提供参考依据。方法:细菌培养严格按照卫生部《全国临床检验操作规程》进行,采用法国生物梅里埃公司API系统进行细菌鉴定。药物敏感试验采用CLSL推荐的纸片扩散法(KB法)进行操作与评价。结果:2010—2011年我院临床共分离出732株革兰阴性杆菌,其中产ESBLs大肠埃希菌和克雷伯菌属检出率分别为65.6%和37.9%。所有革兰阴性杆菌对亚胺培南耐药率均<7%;肠杆菌属对哌拉西林/他唑巴坦和阿米卡星耐药率也较低,为22.1%;志贺菌属、枸橼酸杆菌属和沙雷菌属对环丙沙星耐药率<25%;变形杆菌属对大多数抗菌药物耐药率<20%;铜绿假单胞菌对头孢他啶和环丙沙星耐药率为14%,而革兰阴性杆菌对其他大多数抗菌药物耐药率表现较高。结论:我院革兰阴性杆菌对常用抗菌药物的耐药性已较为严重,应加强对抗菌药物使用的管理力度,遏制细菌耐药性快速增长的不良趋势。Objective：To understand drug-resistance of clinical isolates of gram-negative bacilli（GNB）in county hospital from 2010 to 2011 and provide the referrence for clinical reasonable use of antibiotics.Method：Pathogenic bacteria were cultured according to the National Guide to Clinical Laboratory Procedures.API system（bioMérieux,France）was used to identify the strain.Drug susceptibility testing was performed by K-B methods recommended by CLSI.And results were assessed.Result：732 GNB were collected in our Hospital from 2010 to 2011.The detection rates of ESBLs producing E.coli and Klebsiella were 65.6% and 37.9%,respectively.Resistance of imipenem against GNB was the lower and all less than 7%.Resistance rates of piperacillin/tazobactam and amikacin against Enterobacter were also lower,being 22.1%.Resistance rates of ciprofloxacin against Shigella,Citrobacter and Serratia were less than 25%.Resistance rates of most antibiotics against Proteus were below 20%.Resistance rates of ceftazidime and ciprofloxacin against Pseudomonas aeruginosa were 14%,while gram-negative bacilli performed higher resistance to most other antibiotics.Conclusion：Resistance of commonly used antibiotics against GNB was severe in our hospital.We should strengthen management of antibiotics use to restrain the increasing tendency of bacterial resistance.

关 键 词：县级医院 革兰阴性杆菌 耐药性 

分 类 号：R379[医药卫生—病原生物学]