近3年临床分离的革兰阴性杆菌耐药性分析  

Analysis of drug resistance of Gram negative bacilli isolated in the recent three years

作　　者：张青[1] 王芳[1] 郭华[1] 候梦君 李碧莲 ZHANG Qing;WANG Fang;GUO Hua;HOU Mengjun;LI Bilian(Department of Clinical Laboratory,Affiliated Hospital of Chengdu University ofTraditional Chinese Medicine,Chengdu,Sichuan 610072,China;Department of Laboratory Medicine,North Sichuan Medical College,Nanchong,Sichuan 637000,China)

机构地区：[1]成都中医药大学附属医院检验科,成都610072 [2]川北医学院检验系,四川南充637000

出　　处：《检验医学与临床》2019年第8期1027-1030,共4页Laboratory Medicine and Clinic

摘　　要：目的分析近3年成都中医药大学附属医院从临床分离的革兰阴性杆菌的耐药性及分布特征,指导临床合理使用抗菌药物。方法收集2014-2016年分离自该院临床的6 749株非重复革兰阴性杆菌,采用Vitek-2compact仪进行鉴定和药敏试验,采用Whonet5.6软件进行数据分析。结果近3年分离的革兰阴性杆菌,以大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、嗜麦芽窄食单胞菌为主,且铜绿假单胞菌的分离率略有上升。大肠埃希菌近3年检出的产超广谱β-内酰胺酶菌株均大于50.0%;鲍曼不动杆菌对替加环素的耐药率最低,对阿米卡星、左氧氟沙星的耐药率分别从2014年27.2%、13.0%增长至2016年47.4%、32.5%。铜绿假单胞菌对头孢吡肟和亚胺培南的耐药率上升,分别从9.4%增长至21.7%,16.0%增长至29.7%。肺炎克雷伯菌对亚胺培南的耐药趋势上升明显,近3年耐药率已由5.6%上升至19.9%。嗜麦芽窄食单胞菌对头孢哌酮/舒巴坦和复方磺胺甲噁唑敏感性降低,耐药率呈上升趋势。结论近3年临床分离的大多数革兰阴性杆菌耐药率呈上升趋势,应加强对医院感染病原菌的耐药性监测,指导临床合理使用抗菌药物。Objective To analyze the resistance of Gram negative bacilli isolated from the Affiliated Hospital of Chengdu University of Traditional in the recent three years,and guide clinical medication.Methods A total of 6 749 strains of non repetitive Gram negative bacilli were collected for analysis from 2014 to 2016,Vitek-2 compact was used for bacterial identification and drug susceptibility testing.Statistical analysis was performed using Whonet 5.6.Results During the recent three years,the main species of Gram negative bacilli were Escherichia coli,Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae and Stenotrophomonas maltophilia,and the isolation rate of Pseudomonas aeruginosa increased slightly.In the recent three years,Escherichia coli strains producing ESBLs were all over 50.0%.Acinetobacter baumannii had the lowest resistance to tigecycline.The drug resistance rates to amikacin and levofloxacin increased from 27.2 %,13.0% in 2014 to 47.4%,32.5% in 2016 respectively.The resistance rate of Pseudomonas aeruginosa to cefepime and imipenem increased from 9.4% to 21.7% and 16.0% to 29.7% respectively.Drug resistance of Klebsiella pneumoniae to imipenem has increased significantly from 5.6% to 19.9%.The susceptibility of Stenotrophomonas maltophilia to tigecycline and cotrimoxazole gradually decreased,and the resistance rates of these Antibiotics increased rapidly.Conclusion In the past three years,the resistance rates of most isolates of Gram-negative bacilli have a rising trend.It is necessary to strengthen drug resistance surveillance of nosocomial infection pathogens for reasonable medication.

关 键 词：革兰阴性杆菌 抗菌药物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]