肠杆菌科细菌耐药性监测  

Surveillance of antimicrobial resistance of Enterobacteriaceae

作　　者：热那古.艾山 木尼热.马合苏提 徐恩洁[1] 季萍[1] 

机构地区：[1]新疆医科大学第一附属医院医学检验中心,乌鲁木齐830054

出　　处：《中国临床药理学杂志》2017年第20期2029-2031,共3页The Chinese Journal of Clinical Pharmacology

摘　　要：目的了解新疆医科大学第一附属医院临床常见肠杆菌科细菌在医院感染中的分布及耐药变迁。方法收集本院2013-2015年临床各类标本中检测的肠杆菌科细菌。用全自动细菌鉴定分析仪进行细菌鉴定,用全自动微生物分析仪进行药敏实验,K-B纸片法进行补充。结果标本来源:呼吸道标本占36%,尿道占34%,无菌体液占17%。菌种分布:第1位的大肠埃希菌占42%,第2位的肺炎克雷伯菌占31%,第3位的阴沟肠杆菌占8%。大肠埃希菌对亚胺培南、美洛培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢替坦、阿米卡星及呋喃妥因的耐药率均小于10%;药物对肺炎克雷伯菌耐药率从高到底依次是亚胺培南、头孢替坦、哌拉西林/他唑巴坦、美洛培南及阿米卡星。大肠埃希菌和肺炎克雷伯菌产ESBL的检出率在2013,2014和2015年分别是41.8%,28.4%;66.4%,41.0%;71.3%,52.4%,且大肠埃希菌的检出率高于肺炎克雷伯菌;对碳青霉烯类耐药的肠杆菌科细菌的检出率:肺炎克雷伯菌为2.3%,高于大肠埃希菌0.6%。结论多重耐药和肠杆菌科细菌检出率逐年增加。Objective To investigate surveillance of antimicrobial resis- tance of Enterobacteriaceae bacteria in the first affiliated hospital of Xin- jiang Medical University. Methods Enterobacteriaceae in clinical spe- cimens of 2013 -2015 years in our hospital were collected. The clinical isolates were identified by the automatic bacterial identification analyzer. The drug sensitivity was determined by Automatic microbiological analy- zer. The K -B paper method was used tosubsidiary experiment. VITEK- 2 compact and VITEK - MS and the susceptibility test was carried out. The KB paper method was supplemented. Results The 11156 strains of Enterobacteriaceae were detected in 3 years, accounting for 65.6% of gram - negative bacilli, the first of E. coli accounted for 42%, the second KlebsieUa pneumoniae accounted for 31%, the third Enterobacter cloacae accounted for 8%. Respiratory tract is the common infection of Enterobacteriaceae accounted for 36%, followed by 34% of the urethra. The resistant rate of Escherichia coli on imipenem, meropenem, cefoperazone/sulbactam, piperaeillin/tazobactam, cefotetan, amikacin and nitrofurantoin were less than 10%. The drug resistance rate against Klebsiella pneumoniae from high to bttom in turn was imipenem, cefotetan, piperacillin/tazobaetam, meropenem, amikacin. The detection rate of ESBL - producing Escherichia coli was higher than that of Klebsiella pneumoniae from 2013 to 2015 （41.8%,28.4% ; 66. 4% ,41.0% ;71.3%, 52. 4% ）. The detection rate of carbapenem - resistant Klebsiella pneumoniae was 2. 3% %, higher than Escherichia coli of 0. 6%. Conclusion Muhidrug resistant bacteria and Enterobacteriaceae detection rate increased year by year.

关 键 词：肠杆菌科细菌 耐药性 医院感染 细菌多重耐药 

分 类 号：R978.1[医药卫生—药品]