耐碳青霉烯类革兰阴性杆菌的耐药性分析  

Drug resistance of carbapenem-resistant gram-negative bacilli

作　　者：韦柳华[1] 黄志卓[1] 李梦薇[1] 彭华[1] 蒋利君[1] 莫善颖[1] 

机构地区：[1]广西医科大学第四附属医院检验科,广西柳州545005

出　　处：《中华医院感染学杂志》2013年第8期1920-1922,共3页Chinese Journal of Nosocomiology

基　　金：广西壮族自治区科学技术厅项目(桂科攻1140003A-43);广西壮族自治区卫生厅项目(Z 2011497)

摘　　要：目的了解耐碳青霉烯类革兰阴性杆菌的临床分布及耐药性,为临床抗感染治疗及合理使用抗菌药物提供依据。方法采用美国Microscan Autoscan-4微生物分析仪对细菌做鉴定,药敏试验采用纸片扩散法及微量肉汤稀释法,药敏结果判断参照CLSI 2010年标准。结果 95株耐碳青霉烯类革兰阴性杆菌主要分布于ICU36株,占37.8%,其次为神经外科26株,占27.3%;以痰液分离最多45株占47.4%,其次为肺泡灌洗液33株占34.7%;泛耐药铜绿假单胞菌的分离率为3.2%,泛耐药鲍氏不动杆菌的分离率为7.1%;鲍氏不动杆菌对头孢哌酮/舒巴坦的耐药率较低为10.7%,铜绿假单胞菌对多黏菌素B、氨基糖苷类的耐药率较低0～16.1%,恶臭假单胞菌对阿米卡星耐药率较低为33.3%,短黄杆菌仅对米诺环素、磺胺甲噁唑/甲氧苄啶敏感,褪色沙雷菌仅对阿米卡星、头孢他啶敏感。结论耐碳青霉烯类革兰阴性杆菌多药耐药现象严重,不同细菌对抗菌药物的耐药状况不同,鲍氏不动杆菌的耐药性比铜绿假单胞菌更严重,因此应谨慎、合理地使用碳青霉烯类抗菌药物,密切关注耐碳青霉烯类革兰阴性杆菌耐药的发展,采取有效的感染控制措施,以更好地控制细菌感染。OBJECTIVE To investigate the distribution and drug resistance of carbapenem-resistant gram-negative bacilli so as to provide basis for the anti-infection therapy and the reasonable use of antibiotics.METHODS The bacterial identification was performed by MicroSCAN Autoscan-4 of American,and the disk diffusion method（Kirby-Bauer） and broth micro dilution method were used to determine the antimicrobial susceptibility,the results were analyzed according to CLSI 2010.RESULTS Of 95 strains of carbapenem-resistant gram-negative bacilli,there were 36（37.8%） strains isolated from ICU and 26（27.3%） strains isolated from the neurosurgery department.There were 45（47.4%）strains isolated from the sputum and 33（34.7%） strains isolated from lavage fluid.The detection rates of the pandrug-resistant Pseudomonas aeruginosa and the pandrug-resistant Acinetobacter baumannii were 3.2% and 7.1%,respectively.The drug resistance rate of A.baumannii strains to cefperazone-sulbactam was 10.7%,the drug resistance rate of P.aeruginosa strains to colistin B and aminoglycosides varied between 0% and 16.1%,the drug resistance rate of the Pseudomonas putida strains to amikacin was 33.3%,the Flavobacterium breve was only sensitive to minocycline and trimethoprim-sulfamethoxazole,Serratia marcescens strains were only sensitive to amikacin and ceftazidime.CONCLUSION The carbapenem-resistant gram-negative bacilli show obviously multidrug-resistant and vary in the drug resistance,the drug resistance of A.baumannii was more serious than that of P.aeruginosa.It is necessary to reasonably use carbapenems antibiotics,to focus on the development of the drug resistance of the carbapenem-resistant gram-negative bacilli,and to take effective control measures so as to effectively control the bacterial infections.

关 键 词：革兰阴性杆菌 碳青霉烯类 耐药性 

分 类 号：R378[医药卫生—病原生物学]