8466株临床常见肠杆菌科细菌耐药性分析  

Drug resistance analysis of 8 466 clinical common Enterobacteriaceae bacteria

作　　者：李怡[1,2] 李婧 王志翔[2] 郑丽华[2] LI Yi;LI Jing;WANG Zhi-xiang;ZHENG Li-hua(People's Hospital of Ningxia Hui Autonomous Region(First Affiliated Hospital of Northwest Minzu University),Yinchuan,Ningxia 750001,China)

机构地区：[1]宁夏回族自治区人民医院(西北民族大学第一附属医院)医院感染管理科,宁夏银川750001 [2]宁夏回族自治区人民医院(西北民族大学第一附属医院)中心实验室,宁夏银川750001 [3]青铜峡市小坝卫生院药房,宁夏青铜峡751600

出　　处：《中华医院感染学杂志》2019年第20期3073-3076,共4页Chinese Journal of Nosocomiology

基　　金：宁夏回族自治区人民医院培育振兴科研基金资助项目(201720)

摘　　要：目的调查2013-2017年医院常见肠杆菌科细菌的临床分布及耐药情况,为指导临床合理使用抗菌药物及针对性的制定医院感染防控措施提供理论依据。方法回顾性分析2013-2017年宁夏回族自治区人民医院临床分离肠杆菌科细菌8466株的科室分布和对常用抗菌药物的耐药情况,并进行菌株鉴定。结果2013-2017年临床共分离肠杆菌科细菌8466株,以大肠埃希菌4106株占48.50%为主,其次为肺炎克雷伯菌3129株占36.96%,第三位为阴沟肠杆菌723株占8.54%;标本以呼吸道、泌尿道为主;大肠埃希菌对亚胺培南耐药率较低为2.24%,对哌拉西林耐药率较高为81.73%;肺炎克雷伯菌对美罗培南耐药率较低为5.15%,对哌拉西林耐药率较高为25.83%;阴沟肠杆菌对美罗培南耐药率较低5.53%,对头孢唑林、头孢呋辛、头孢西丁、阿莫西林/克拉维酸耐药率均>95%。结论医院分离的肠杆菌科细菌主要分布在插管频次较高的科室,且对抗菌药物呈现不同程度的耐药,临床在治疗肠杆菌科细菌感染时应根据其耐药表型及药敏试验结果谨慎使用碳青霉烯类药物,同时严格落实消毒隔离措施,避免交叉感染。OBJECTIVE To investigate the clinical distribution and drug resistance of common Enterobacteriaceae bacteria in hospitals from 2013to 2017,and to provide the theoretical basis for guiding the rational use of antibiotics in clinic and for making the prevention and control measures for nosocomial infections.METHODS The department distribution and drug resistance of 8466strains of Enterobacteriaceae isolated from the people's Hospital of Ningxia Hui Autonomous region from 2013to 2017were analyzed retrospectively,and the strains were identified.RESULTS A total of 8466strains of Enterobacteriaceae were isolated from 2013to 2017,including 4106strains of Escherichia coli(48.50%),3129strains of Klebsiella pneumoniae(36.96%)and 723strains of Enterobacter cloacae(8.54%).The main specimens were respiratory tract and urinary tract.The resistance rate of E.coli to imipenem was 2.24%,to piperacillin was 81.73%;the resistance rate of K.pneumoniae to meropenem was 5.15%,to piperacillin was 25.83%;the resistance rate of E.cloacae to meropenem was 5.53%,to cefazolin,cefuroxime,cefoxitin and amoxicillin/clavulanic acid was all higher than 95%.CONCLUTIONThe Enterobacteriaceae bacteria are mainly isolated from the departments with high intubation frequency,and have resistances to different antibacterial drugs.Clinically,in the treatment of Enterobacteriaceae bacterial infection,carbapenem should be used cautiously according to the results of drug resistance phenotype and drug sensitivity test,and strictly implementing disinfection and isolation measurements to avoid cross-infection.

关 键 词：肠杆菌科细菌 临床分布 耐药性 

分 类 号：R378.2[医药卫生—病原生物学]