某院五年间粘质沙雷菌的分布及耐药性分析  

Distribution and Drug resistance Analysis of Serratia marcescens in our hospital During Five Years

作　　者：王晓丽[1] 葛亮[1] 李兴华[1] WANG Xiao li;GE Liang;LI Xing hua(The Second Affiliated Hospital of Xinjiang Medical University,Xinjiang,Urumqi,830028,China)

机构地区：[1]新疆医科大学第二附属医院检验科,乌鲁木齐830028

出　　处：《新疆医学》2018年第9期960-963,共4页Xinjiang Medical Journal

基　　金：新疆维吾尔自治区自然科学基金(2016D01C195)

摘　　要：目的探讨本院2013年1月-2017年12月粘质沙雷菌在感染中的分布及对常用抗生素的耐药特征,以指导临床合理使用抗菌药物。方法细菌鉴定采用法国生物梅里埃公司VITEK-2compact的GN鉴定卡,药敏试验采用kirby-bauer扩散法。应用Whonet5.4、SPSS13.0软件进行统计分析。结果五年中共分离出161株粘质沙雷菌,分离率呈逐年增高的趋势。其中呼吸道标本的分离率最高,为55.28%,其次是尿液为14.29%。科室以老年病科检出率最高,占21.12%。总耐药率数据显示:头孢噻肟的耐药率最高,为42.9%,其次是头孢曲松、头孢哌酮及庆大霉素,耐药率分别为31.7%、24.2%及23.6%,余者抗生素耐药率均≤18.0%;阿米卡星的抗菌活性最强,耐药率为1.2%,其次是哌拉西林/他唑巴坦及头孢吡肟耐药率分别为1.9%及2.5%,再其次是亚胺培南及美罗培南,耐药率均为3.7%。碳青霉烯类抗生素厄他培南、亚胺培南及美罗培南,2013年和2014年未检出耐药,2015-2017年出现耐药,且厄他培南的敏感率要低于亚胺培南及美罗培南。2013-2015年头孢哌酮/舒巴坦未检出耐药,而2016-2017年耐药呈上升势态。2013-2016年哌拉西林/他唑巴坦及阿米卡星未检出耐药,2017年的耐药率分别为5.6%及3.7%。2013年左氧氟沙星未检出耐药,2014-2017年均出现耐药,以2016年耐药率最高,占13.5%。结论粘质沙雷菌检出率呈逐年升高的态势,其耐药率也在逐年升高,应加强对耐药菌株的管控,及时切断耐药菌株的水平传播。Objective To explore the distribution of Serratia marcescens if infection was occurred and the drug resistance characteristics of common antibiotics from January 2013 to December 2017, and to provide guidance for reasonable clinical use of antibiotics. Methods The bacterial identification was performed by using the GN identification card of VITEK2-Compact automatic instrument from French Bio-Merieux. Kirby-Bauer method was carried out to test the antimicrobial susceptibility and the statistical analysis was performed with Whonet 5.4 and SPSS 13.0 software. Results A total of 161 Serratia marcescens were isolated in five years.The separation rate was increasing year by year. The separation rate in respiratory specimens was the highest, accounting for 55.28%. The second highest organ was urine, which accounts for 14.29%. In each department, the detection rate of geriatric diseases was the highest,accounting for 21.12%.Total drug resistance rate data showthat Cefotaxime had the highest drug resistance rate for 42.9%. The second was ceftriaxone, cefoperazone and gentamicin, the resistance rate were 31.7%, 24.2% and 23.6% respectively. The remaining antibiotic resistance rate was lower than 18.0%. The antibacterial activity of amikacin was the strongest, and the drug resistance rate was 1.2%. The second strongest activity was piperacillin/tazobactam and cefepime, and resistance rate was 1.9% and 2.5% respectively. The third strongest activity was imipenem and meropenem, and the drug resistance rate was 3.7%. In 2013 and 2014, there was no drug resistance for the carbapenems antibiotics etapenem, imipenem and meropenem. But the drug resistance was found between 2015 and 2017, and the sensitivity of etapenem was lower than that of imipenan and meropenan. Cefoperazone/sulbactam failed to detect drug resistance from 2013 to 2015. Resistance rate of cefoperazone/sulbactam increased from 2016 to 2017. In 2013 to 2016, piperacillin/tazobactam and amikacin failed to detect drug resistance, and their drug resistance rates were

关 键 词：粘质沙雷菌 分布 耐药性 

分 类 号：R-3[医药卫生]