2012-2014年某医院常见革兰阴性杆菌耐药率的变移  

The changes of drug resistance of common gram-negative bacilli in a hospital during the period of 2012-2014

作　　者：李竟[1,2] 郭普[2] 钟政荣[2] 袁媛[3] 沈继龙[1] 

机构地区：[1]安徽医科大学病原生物学教研室,安徽合肥230032 [2]蚌埠医学院第一附属医院检验科,安徽蚌埠233004 [3]蚌埠医学院第一附属医院核医学科,安徽蚌埠233004

出　　处：《中华疾病控制杂志》2015年第10期1042-1046,共5页Chinese Journal of Disease Control & Prevention

基　　金：蚌埠医学院科研课题(BYKY1452)

摘　　要：目的了解蚌埠医学院第一附属医院2012-2014年常见革兰阴性菌耐药率的变移,为临床合理使用抗生素提供依据。方法药敏实验采用自动化仪器法或纸片扩散法。结果临床共分离出13 488株细菌,其中革兰阴性菌8 384株,排名前4位的是:大肠埃希菌40.4%(3 384/8 384)、肺炎克雷伯菌13.6%(1 138/8 384)、鲍曼不动杆菌10.4%(868/8 384)、铜绿假单胞菌9.0%(757/8 384),占分离革兰阴性菌的73.3%。大肠埃希菌、肺炎克雷伯菌产超广谱β-内酰胺酶菌株的检出率分别为67.8%和39.6%。肠杆菌科细菌(除粘质沙雷菌)对碳青霉烯类抗生素保持高度敏感性。鲍曼不动杆菌和铜绿假单胞菌对亚胺培南三年的耐药率分别大于77.1%和23.3%,广泛耐药鲍曼不动杆菌和铜绿假单胞菌的检出率为:84.8%和37.5%。结论该院临床分离的革兰阴性菌耐药情况严重,值得关注的是泛耐药及碳青霉烯类抗生素耐药菌株呈明显的逐年上升趋势,应引起高度重视。Objective To investigate the changes of drug resistance rate of common gram-negative bacilli in the first Affiliated Hospital of Bengbu Medical College during 2012 - 2014, and to provide reference for rational use of antimicrobial agents in clinical practice. Methods Drug sensitivity test was conducted by either automatic instruments or disk diffusion method. Results 13 488 strains of bacteria, including 8 384 gram-negative strains, were isolated during 2012 - 2014. The top 4 bacterial strains, which accounted for 73.3% of the total gramnegative bacteria, were E. coli （40. 4%, 3 384/8 384）, Klebsiella pneumoniae （13.6%, 1 138/8 384）, Acinetobacter baumannii （10. 4%, 868/8 384）, and Pseudomonas aeruginosa （9.0%, 757/8 384）. The positive rates of E. coli and Extended-spectrum β-lactamases （ESBLs） produced by K. pneumoniae were 67.8% and 39.6% , respectively. Enterobacteriaceae bacterium （ excluding serratia marcescens ） remain highly sensitive to carbapenems. The resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa to imipenem in the last three years were above 77. 1% and 23.3%, respectively. The positive rates of pan-drug resistant Acinetobacter baumannii and P. aeruginosa were 84. 8% and 37.5%, respectively. Conclusions The drug resistance of clinically isolated gram-negative bacilli was in a serious situation in the Hospital investigated. A rising tendency of pan-drug resistant and carbapenems resistant strains was observed and close attention should be paid accordingly.

关 键 词：革兰氏阴性菌 抗药性 细菌 流行病学研究 

分 类 号：R378[医药卫生—病原生物学]