2012—2014年某教学医院肠杆菌科细菌耐药率变迁  

Change in antimicrobial resistance of enterobacteriaceae from 2012 to 2014 in a teaching hospital

作　　者：康海全[1] 邓丽华[1] 姜飞[1] 赵晓杰[1] 马萍[1] 顾兵[1] 

机构地区：[1]徐州医学院附属医院检验科,江苏徐州221002

出　　处：《中华全科医学》2016年第2期275-278,共4页Chinese Journal of General Practice

摘　　要：目的了解某医学院附属医院2012—2014年肠杆菌科细菌的标本类型、送检科室分布情况及3年间的耐药性变迁情况。方法收集3年间医院临床微生物室临床首次分离的肠杆菌科细菌,采用美国BD公司Phoenix100全自动微生物分析系统进行菌种鉴定和抗菌药物敏感试验,药敏结果判断标准遵循CLSI2013指南,数据结果采用WHONET5.6软件进行分析。结果 2012—2014年医院共收集首次分离肠杆菌科细菌9 031株,送检科室以重症医学科(ICU)、神经外科、神经内科、泌尿科和呼吸内科为主;标本类型以呼吸道、泌尿道、血液标本、分泌物、胸腹水和脑脊液为主;病原菌以肺炎克雷伯菌、大肠埃希菌、奇异变形杆菌、阴沟肠杆菌、粘质沙雷菌和产气肠杆菌为主;药物敏感试验显示碳青霉稀类、加酶抑制剂和氨基糖苷类抗菌药物敏感率较高,其余抗菌药物敏感率均较低。结论肠杆菌科细菌是医院重要的病原菌,对多种抗菌药物均表现为高水平耐药和多重耐药。目前,碳青霉烯类抗菌药物仍然是治疗肠杆菌科细菌临床感染的最佳选择,但是,碳青霉烯类耐药的肠杆菌科细菌(Carbapenem-Resistant Enterobacteriaceae,CRE)已经出现,且呈增多趋势,需加强CRE监测和规范临床合理用药,以遏制CRE在医院内的传播。Objective To investigate the trend of specimen source, distribution and antimicrobial agents resistance of Enterobacteriaceae from 2012 to 2014. Methods Enterobacteriaceae isolated from a affiliated hospital of a Medical College were identified by BD Phoenix. and the data were judged with CLSI2013 and analyzed with WHONETS. 6. Results A total of 9 031 strains of Enterobacteriaceae were collected, and mainly come from the ICU, neurology, neurosurgery, urology, and respiratory department, and mainly come from specimens of sputum, urine, blood. Secretion, ascites and cerebrospinal fluid. The strains mainly included Klebsiella pneumoniae, Escherichia coli, Proteus mirabilis, Enterobacter cloacae, Serratia marcescens and Enterobacter aerogcnes. The strains showed high sensitivity ratio for carbapenems, enzyme inhibitor and amino glycosides. Conclusion Enterobacteriaceaes were mainly pathogen in the hospital, and expressed high resistance for most antibiotics. Carbapenems were still the optimum selection for control infections of Enterobaeteriaceae, but Carbapenem-Resistant Enterobacteriaceae（CRE） already appeared increasingly. Clinicians should pay attention to CRE and promote the rational use of antimicrobial agents to avoid the spread of CRE in hospital.

关 键 词：肠杆菌科细菌 碳青霉烯耐药的肠杆菌科细菌 耐药 

分 类 号：R378.2[医药卫生—病原生物学] R446.5[医药卫生—基础医学]