阴沟肠杆菌感染的临床分布及耐药性变迁分析  

Infections caused by enterobacter cloacae: clinical distribution and antimicrobial resistance

作　　者：张弓[1] 罗润齐[1] 林红燕[1] 

机构地区：[1]广州医科大学附属第二医院,广州510260

出　　处：《广州医药》2015年第6期51-53,共3页Guangzhou Medical Journal

摘　　要：目的了解近5年来阴沟肠杆菌在我院的临床分布及耐药性的变迁情况。方法采用K-B纸片法进行药物敏感性测定,再用双纸片法检测超广普β-内酰胺酶(ESBLs)。结果 2010年1月—2014年12月我院共分离阴沟肠杆菌261株,其中2010年分离48株(18.4%)、2011年50株(19.2%)、2012年52株(19.9%)、2013年54株(20.7%)、2014年57株(21.2株%);主要分布于重症监护室(ICU)、呼吸内科、肝胆外科,分别占49.%(130株)、14.9%(39株)、11.9%(31株),标本来源主要为痰液、尿液及伤口分泌物,分别占52%、13.5%、12.8%,ESBLs菌株的检出率为29.9%(78株),产酶株的耐药性高于非产酶株,全部菌株对亚胺培南敏感。结论阴沟肠杆菌主要引起呼吸道、尿路和各种伤口感染,多发于ICU患者,并且呈逐年增多趋势,产ESBLs在阴沟肠杆菌中广为流行,合理使用抗菌药物(尤其是第三代头孢菌素)是减少产ESBLs株流行的重要措施。Objective To investigate the clinical distribution and antimicrobial resistance of infections caused by enterobacter cloacae in our hospital. Methods Antimicrobial susceptibility tests were done by Kirby-Bauer disk diffusion method.The extended-spectrum β- Lactamases（ ESLBS） were detected by double disc diffusion test. Results A total of 261 strains of E cloacae were isolated from Jan 2010 to Dec 2014. The percentages of these strains isolated in 2010,2011,2012,2013,2014 were 18. 4%,19. 2%,19. 9%,20. 7%,21. 2% respectively. E cloacae were mainly isolated from intensive care unit（ ICU）（ 49. 0%）,respiratory medicine（ 14. 9%） and surgery（ 11. 9%） respectively. The percentages of these strains isolated from sputum,urine and wound secretion were 52. 0% 13. 5% and 12. 8% respectively. The percentages of ESBLS producer was29. 9%（ 78 strains）. Their resistance was obviously higher than that of non-ESBLS producer. But all strain were sensitive to imipenem. Conclusion E Cloacae caused infections of respiratory tract,urinary and wound principally in clinic. The most of which occured in ICU. The ESBLS are popular in E cloacae and show the increasing trend year by year. The restricted use of antimicrobial drug is a considerable measure which reduces prevalence of ESBLS producing strains.

关 键 词：阴沟肠杆菌 耐药性 Β-内酰胺酶 

分 类 号：R446.5[医药卫生—诊断学]