2011-2015年某院分离3种常见肠杆菌分布及耐药性分析  

Study on distribution and drug resistance of three common Enterobacteriaceae strains in a hospital from 2011 to 2015

作　　者：陈晓青[1] 魏莲花[2] 李可可[1] 朱吉超[3] 杨永清[1] 邵海鑫 邹凤梅[2] 刘刚[2] 吴玲[2] 李军春[2] 魏勤[2] 陈玉芊[2] 王欣[2] 

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃省人民医院检验中心,甘肃兰州730000 [3]宁夏医科大学临床学院,宁夏银川750004

出　　处：《现代预防医学》2017年第8期1524-1527,共4页Modern Preventive Medicine

基　　金：甘肃省兰州市科技局资助项目(2014-1-4)

摘　　要：目的研究2011-2015年某院常见肠杆菌的分离及耐药情况,为临床合理用药提供参考。方法收集该院5年分离的常见肠杆菌,Vitek 2 Compact全自动微生物分析系统结合基质辅助激光解吸电离飞行时间质谱仪(MALDI-TOF)完成细菌鉴定,K-B法进行药敏实验,WHONET 5.6软件数据分析。结果 5年分离常见肠杆菌6 908株,总分离率为44.7%。标本主要为痰液,占39.1%,其次为尿液和伤口拭子,分别占15.3%和7.9%。大肠埃希菌对青霉素类、头孢菌素类或喹诺酮类等药物的耐药率大于50.0%,对酶抑制剂复合制剂和碳青霉烯类药物的耐药率分别低于15.0%和2.0%。产超广谱β-内酰胺酶(Extended-Spectrum Beta-Lactamase,ESBLs)的肺炎克雷伯菌维持在28.4%~34.8%,肺炎克雷伯菌对各类药物的耐药率均小于50.0%。5年间,阴沟肠杆菌的ESBLs阳性率逐年升高,2015年达100.0%,阴沟肠杆菌对青霉素类、磺胺类、头孢菌素类、酶抑制剂复合制剂等药物的耐药率较高;对亚胺培南和美罗培南最为敏感,耐药率在10.0%以下。结论该院近5年分离的常见肠杆菌呈现不同程度耐药,临床治疗应根据药敏结果选择合理的抗菌药物。Objective To investigate the clinical distribution and drug resistance of the common Enterobacteriaceae strains in our hospital from 2011 to 2015 so as provide reference for the rational choice of antibiotics. Methods Common Enterobacteriaceae strains were collected in five years and identified through Vitek 2 Compact automatic microbial analysis system （ Vitek 2 Compact） combined with matrix-assisted laser desorption/ ionization-time of flight mass spectrometry （ MALDI-TOF MS）. The drug sensitivity testing was carried out by using disk diffusion method （K-B method） and the results were statistically analyzed by WHONET 5.6 software. Results A total of 6908 common Enterobacteriaceae strains were isolated in the five years, accounting for 44.7% of all the strains. The specimens were mainly come from sputum, accounting for 39.10%, and secondly come from urine and wound swab, accounting for 15.3% and 7.9%, respectively. Escheriehia coli highly resistant to penicillins, eephalothins and quinolones （≥50%）, while the resistance rates of enzyme inhibitor drugs and carbapenem were lower than 15.0% and 2.0%, respectively. Production rate of extended-spectrum beta-lactamases （ESBLs） in Klebsiella pneumoniac maintained 28.4%-4.8%, the resistant rates of Klebsiella pneumoniae to all kinds of antimicrobial agents were below 50.0%. ESBL-positive rate of Enterobacter cloacae strains has been increasing, and the detection rate was 100.0% in 2015; The antibiotic resistance rate of Enterobaeter cloacae to penieillins, sulfonamides, cephalosporins and enzyme inhibitors were high; mipenem and meropenem are the most sensitive antimicrobial agents of Enterobacter cloacae, resistance rate remained below 10.0%. Conclusion Common Enterobaeteriaeeae bacteria showed varying degrees of resistance in nearly 5 years, and he treatment should select rational antimicrobial agents according to the drug sensitive test results.

关 键 词：肠杆菌科细菌 细菌耐药性 医院感染 

分 类 号：R378.2[医药卫生—病原生物学]