2010-2011年临床革兰阴性杆菌耐药性文献分析  

Literatures about the clinical distribution and drug resistance of gram negative bacilli from 2010 to 2011

作　　者：吴小玲[1] 姜晨辉[1] 何欢[1] 刘俊[1] 

机构地区：[1]南昌大学抚州医学分院药理教研室,江西抚州344000

出　　处：《中华医院感染学杂志》2013年第23期5795-5797,共3页Chinese Journal of Nosocomiology

基　　金：江西省卫生厅科技计划基金项目(20122027)

摘　　要：目的调查临床革兰阴性杆菌分布及耐药性，为临床医师合理使用抗菌药物提供科学依据。方法以革兰阴性杆菌耐药性、细菌耐药性为关键词检索中国期刊全文数据库（CNKI）2010—2011年文献，选取中文核心期刊要目总览（2008年）中的检测方法相同、检测标准相同、统计方法相同的文献共108篇，统计分析革兰阴性杆菌分布及耐药率。结果临床分离的革兰阴性杆菌所占比例为67．1％，居前6位的依次为大肠埃希菌、铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌、阴沟肠杆菌、嗜麦芽寡养单胞菌；对于肠杆菌科细菌，敏感性最高的抗菌药物为碳青霉烯类，耐药率在0．6％～4．5％，敏感性最低的抗菌药物为氨苄西林，耐药率在65．1%～93．0％；而非发酵革兰阴性杆菌中，鲍氏不动杆菌对所调查的19种抗菌药物的耐药率普遍较高，耐药率〉50．0％有14种。结论肠杆菌科细菌对抗菌药物呈现不同程度的耐药，碳青霉烯类抗菌药物是活性最高的药物；非发酵革兰阴性杆菌耐药性十分严重，应引起临床高度重视。OBJECTIVE To investigate the clinical distribution and drug resistance of gram-negative bacilli, and to provide scientific basis for rational use of antimicrobial drugs. METHODS Gram-negative bacilli and bacterial drug resistance were used as key words to search the literature published from 2010 to 2011 in Chinese Journal Full-text Database （CNKI）, and a total of 108 papers with the same test method, teat standard and statistical method in GCJC （2008） were selected. Statistical analysis was performed to acquire the distribution and drug resistance rate of gram-negative bacilli. RESULTS Gram-negative bacilli of clinical isolates accounted for 67.1%, among them, Escherichia coli , Pseudomonas aeruginosa , Acinetobacter baumannii , Klebsiella pneumoniae , Enterobacter cloa-cae and Stenotrophomonas rnaltophilia ranked in the top six. Enterobacteriaceae had the highest sensitivity to carbapenems, of which the drug resistance rate was 0.6 %-4.5 %, and had the lowest sensitivity to ampicillin, of which the drug resistance rate was 65.1% - 93.0%. As far as non-fermenting gram-negative bacteria, the drug resistance rates of Acinetobacter baurnannii to the investigated 19 kinds of antimicrobial drugs were generally higher, and the rates to14 kinds were〉 50.0 %. CONCLUSION Enterobacteriaceae shows varying degrees of drug resistance to antimicrobial drugs, and carhapenems are the most active antimicrobial drug; the drug resistance rate of non-fermenting gram-negative bacilli is very high, and should be attached great clinical importance.

关 键 词：革兰阴性杆菌 耐药性 文献调查 

分 类 号：R378[医药卫生—病原生物学]