阴沟肠杆菌的感染分布及耐药性分析  

Distribution of and drug resistance of Enterobacter cloacaes

作　　者：蒙雨明[1] 韦柳华[1] 彭华[1] 

机构地区：[1]广西医科大学第四附属医院

出　　处：《中华医院感染学杂志》2013年第17期4284-4285,4288,共3页Chinese Journal of Nosocomiology

基　　金：广西科学研究与技术开发计划项目(桂科攻1140003A-43);广西壮族自治区卫生厅科研项目(Z2011497)

摘　　要：目的了解阴沟肠杆菌的临床分布及耐药性，为临床抗感染治疗与合理使用抗菌药物提供依据。方法采用美国Microscan Amoscan-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。结果阴沟肠杆菌主要分布于骨科占17. 9%，其次为耳鼻喉科占11. 6%，神经外科占10. 5%;标本分布以分泌物分离最多占24.2%，其次为痰液、脓液，分别占23. 2%、13.2%;阴沟肠杆菌对亚胺培南、阿米卡星、哌拉西林/他唑巴坦、庆大霉素、左氧氟沙星、环丙沙星、头孢吡肟的耐药率在0-27.4%，对头孢西丁、头孢唑林的耐药率〉90.0%。结论阴沟肠杆菌主要引起伤口及呼吸道感染；合理使用抗菌药物仍是控制阴沟肠杆菌耐药的关键，选择抗菌药物要以药敏结果为依据；密切关注阴沟肠杆菌耐药的发展，采取有效的感染控制措施，遏制该菌引起的医院感染。OBJECTIVE To investigate the clinical distribution and drug resistance of Enterobacter cloacae so as toguide the clinical antiinfection treatment and the reasonable use of antibiotics. METHODS The bacterial identification was performed by using automatic Microscan Autoscan-4 （USA）,then the drug susceptibility testing was performed by disc diffusion method and broth microdilution method, and the result of drug susceptibility testing wasdetermined by referring to CLSI （2010）. RESULTS Of the patients with E. cloacae infections, 17. 9% were fromthe orthopedics department, 11. 6% from ENT department,and 10. 5% from neurosurgery department. As forthe clinical specimens, 24. 2% were collected from secretions, 23. 2% from sputum, 13. 2% from pus. The resultof the drug susceptibility testing concluded that imipenem,amikacin, piperacillin/tazobactam, gentamicin, levo-floxacin,ciprofloxacin, and cefepime showed strong antimicrobial activity against the E. cloacae,with the drugresistance rate ranging between 0 and 27. 4 %,and showed the lowest antibacterial activity against cefoxitin and cefazolin, with the drug resistance rate more than 90. 0%. CONCLUSION The E. cloacae strains usually cause thewound or respiratory tract infections, the key to control drug resistance is the rational use of antimicrobial agents,and the selection of antibiotics should be based on the result of drug susceptibility testing. Focusing on the devel-opment of drug resistance of E, cloacae and taking effective measures to control infections may contribute to theprevention of the E. cloacae infections.

关 键 词：阴沟肠杆菌 抗菌药物 药敏试验 

分 类 号：R378[医药卫生—病原生物学]