革兰阴性菌耐药性连续9年监测结果分析  

A 9-year consecutive surveillance of drug resistance of gram-negative bacteria

作　　者：董一华[1] 俞富军[2] 潘瑜[3] 王伟[1] 卢显万[1] 曹江涛[4] 潘景业[1] 

机构地区：[1]温州医学院附属第一医院ICU,浙江温州325000 [2]温州医学院附属第一医院感染科,浙江温州325000 [3]温州医学院药学院,浙江温州325000 [4]解放军总医院RICU,北京100039

出　　处：《中华医院感染学杂志》2013年第18期4521-4523,共3页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金项目(Y207635)

摘　　要：目的了解医院革兰阴性菌耐药变迁,为合理选择抗菌药物提供参考。方法收集2003-2011年温州医学院附属第一医院患者送检标本进行培养,对分离出的病原菌进行鉴定和药敏试验。结果 9年共检测出革兰阴性菌32 893株,较常见的革兰阴性菌依次为鲍氏不动杆菌、铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌,分别占23.9%、21.2%、20.7%、10.6%;历年耐药率最低的是头孢哌酮/舒巴坦,9年间耐药率波动在7.3%～20.7%;9年大肠埃希菌对亚胺培南/西司他丁耐药率最低,均<0.6%;肺炎克雷伯菌对亚胺培南/西司他丁耐药率最低,在0～2.4%;铜绿假单胞菌对妥布霉素的耐药率最低,在3.9%～19.0%;鲍氏不动杆菌对头孢哌酮/舒巴坦的耐药率最低,在9.9%～34.3%。结论医院革兰阴性菌耐药情况日趋严重,亚胺培南/西司他丁对肠杆菌科细菌仍然保持非常高的敏感性;9年间医院临床分离的革兰阴性杆菌耐药率有较快增长,加强耐药性监测、合理使用抗菌药物非常重要。OBJECTIVE To survey and analyze the change of antibiotic resistance of gram-negative bacteria in Wenzhou so as to guide the reasonable use of antibiotics. METHODS The clinical specimens obtained from the hospital were collected for bacterial culture from 2003 to 2011, then the identification and drug susceptibility testing for the isolated pathogens were performed. RESULTS A total of 32 893 strains of pathogens were detected during the nine years; the Acinetobacter baumannii （23. 9%）, Pseudomonas aeruginosa （21. 2%）, Escherichia coli （20.7 %） and Klebsiella pneumonia （10.6 % ） were the most common species of gram-negative bacteria. The drug resistance rte to cefoperazone/sulbactam was the lowest, varying between 7.3 % and 20.7 % in the nine years; the drug resistance rate of the E. coli to imipenem/cilastatin was the lowest in the nine years （less than 0.6%）; the drug resistance rate of the K. pneumoniae to imipenem/cilastatin was the lowest, varying between 0 and 2.4%; the drug resistance rate of the P. aeruginosa to tobramycin was the lowest, varying between 3.9%and 19.0%; the drug resistance rate of the A. baumannii to cefaperazone/sulbactam was the lowest, varying between 9.9 % and 34.3 %. CONCLUSION The drug resistance of the gram-negative bacteria isolated from Wenzhou becomes increasing serious, imipenem/cilastatin remains very high sensitivity to the Enterobacteriaceae. The drug resistance rate of the clinical isolates of gram-negative bacilli increases rapidly in the nine years. It is very important to enhance the monitoring of drug resistance and use antibiotics reasonably.

关 键 词：革兰阴性菌 耐药监测 耐药性 

分 类 号：R378[医药卫生—病原生物学]