中外医学研究
中外醫學研究
중외의학연구
CHINESE AND FOREIGN MEDICAL RESEARCH
2013年
16期
51-53
,共3页
革兰氏阴性杆菌%药物监测%耐药性
革蘭氏陰性桿菌%藥物鑑測%耐藥性
혁란씨음성간균%약물감측%내약성
Gram-negative bacillus%Drug monitoring%Resistance to drugs
目的:了解医院临床分离革兰氏阴性杆菌的发生率,并进行耐药监测.方法:收集2011-2012年笔者所在医院非重复临床分离革兰阴性菌5548株,VITEK2全自动细菌鉴定仪进行菌株鉴定和药敏试验.结果:医院院内感染革兰氏阴性杆菌前5位病原菌依次为铜绿假单胞菌(32.7%)、大肠埃希菌(23.6%)、鲍曼不动杆菌(23.0%)、肺炎克雷伯菌(6.9%)、奇异变形杆菌(5.3%).大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌中产ESBLs阳性率分别为48.4%、31.8%和13.4%,未发现对亚胺培南和美罗培南耐药的菌株.铜绿假单胞菌对美罗培南、亚胺培南、头孢哌酮-舒巴坦、阿米卡星、妥布霉素、哌拉西林-他唑巴坦的敏感率为81.3%、79.3%、77.0%、67.2%、63.9%、60.9%.鲍曼不动杆菌仅对米诺环素、头孢哌酮-舒巴坦耐药,耐药率为30.4%和48.2%,其他抗菌药物耐药率均在80.0%以上.结论:本次分离菌中鲍曼不动杆菌较2010年前有所增多,且大多来自ICU,鲍曼不动杆菌对亚胺培南和美罗培南的敏感率下降,泛耐株约占80.0%,耐药状况严重.临床分离革兰氏阴性杆菌对常用抗菌药物耐药性呈增长趋势,ESBLs、CRPA、CRAB检出率增加显著,应加强抗生素的合理使用和医院感染控制.
目的:瞭解醫院臨床分離革蘭氏陰性桿菌的髮生率,併進行耐藥鑑測.方法:收集2011-2012年筆者所在醫院非重複臨床分離革蘭陰性菌5548株,VITEK2全自動細菌鑒定儀進行菌株鑒定和藥敏試驗.結果:醫院院內感染革蘭氏陰性桿菌前5位病原菌依次為銅綠假單胞菌(32.7%)、大腸埃希菌(23.6%)、鮑曼不動桿菌(23.0%)、肺炎剋雷伯菌(6.9%)、奇異變形桿菌(5.3%).大腸埃希菌、肺炎剋雷伯菌、奇異變形桿菌中產ESBLs暘性率分彆為48.4%、31.8%和13.4%,未髮現對亞胺培南和美囉培南耐藥的菌株.銅綠假單胞菌對美囉培南、亞胺培南、頭孢哌酮-舒巴坦、阿米卡星、妥佈黴素、哌拉西林-他唑巴坦的敏感率為81.3%、79.3%、77.0%、67.2%、63.9%、60.9%.鮑曼不動桿菌僅對米諾環素、頭孢哌酮-舒巴坦耐藥,耐藥率為30.4%和48.2%,其他抗菌藥物耐藥率均在80.0%以上.結論:本次分離菌中鮑曼不動桿菌較2010年前有所增多,且大多來自ICU,鮑曼不動桿菌對亞胺培南和美囉培南的敏感率下降,汎耐株約佔80.0%,耐藥狀況嚴重.臨床分離革蘭氏陰性桿菌對常用抗菌藥物耐藥性呈增長趨勢,ESBLs、CRPA、CRAB檢齣率增加顯著,應加彊抗生素的閤理使用和醫院感染控製.
목적:료해의원림상분리혁란씨음성간균적발생솔,병진행내약감측.방법:수집2011-2012년필자소재의원비중복림상분리혁란음성균5548주,VITEK2전자동세균감정의진행균주감정화약민시험.결과:의원원내감염혁란씨음성간균전5위병원균의차위동록가단포균(32.7%)、대장애희균(23.6%)、포만불동간균(23.0%)、폐염극뢰백균(6.9%)、기이변형간균(5.3%).대장애희균、폐염극뢰백균、기이변형간균중산ESBLs양성솔분별위48.4%、31.8%화13.4%,미발현대아알배남화미라배남내약적균주.동록가단포균대미라배남、아알배남、두포고동-서파탄、아미잡성、타포매소、고랍서림-타서파탄적민감솔위81.3%、79.3%、77.0%、67.2%、63.9%、60.9%.포만불동간균부대미낙배소、두포고동-서파탄내약,내약솔위30.4%화48.2%,기타항균약물내약솔균재80.0%이상.결론:본차분리균중포만불동간균교2010년전유소증다,차대다래자ICU,포만불동간균대아알배남화미라배남적민감솔하강,범내주약점80.0%,내약상황엄중.림상분리혁란씨음성간균대상용항균약물내약성정증장추세,ESBLs、CRPA、CRAB검출솔증가현저,응가강항생소적합리사용화의원감염공제.
Objective:To investigate the incidence of the clinical isolates gram-negative bacilli and monitor the drug resistance surveillance.Methods:Collecting a total of 5548 non-duplicate clinical isolates of Gram-negative bacteria in 2011-2012.The identification of bacteria and susceptibility test were performed using VITEK2 automatic bacteria idenificator.Results:Pseudomonas aeruginosa(32.7%),escherichia coli(23.6%),acinetobacter baumannii(23.0%),pneumonia gramsReber bacteria (6.9%),proteus mirabilis(5.3%) were most frequently isolated.Escherichia coli,klebsiella pneumoniae,proteus mirabilis in ESBLs positive rate were 48.4%,31.8%and 13.4%,ESBLs producing strains were the important pathogens of nosocomial infection;Imipenem and meropenem resistant strains were not found.The susceptibility rates of pseudomonas aeruginosa to meropenem,imipenem,cefoperazone-sulbactam,amikacin,tobramycin,piperacillin-tazobactam respectively were 81.3%,79.3%,77.0%,67.2%,63.9%,60.9%.The susceptibility rate of Baumanil to minocycline,and cefoperazone-sulbactam were 30.4%and 48.2%.The other antibiotics resistance rate were above 80.0%.Conclusion:Compared to 2010,acinetobacter baumannii is increased,amomn these isolation strains and mostly came from ICU,the sensitive rates of acinetobacter baumannii to imine-south and meropenem is decline,pan-resistant strains account for about 80.0%and drug resistance is serious,a growing trend of the clinical isolates Gram-negative bacilli to common biotics was showed.The detection rate of ESBLs,CRPA and CRAB is increasing significantly.It is the most important and valuable to strength the rational selection of antimicrobial agents and control the nosocomial infections.
