【摘要】 目的了解2008年医院临床感染性疾病中常见革兰阴性杆菌的种类、分布及耐药状况,为临床合理使用抗菌药物提供依据。方法应用ATB Expression自动细菌鉴定系统对菌种进行鉴定,用K-B纸片扩散法对病原菌进行药物敏感性试验,按CLSI 2008年规定标准进行判断。结果从临床标本中共分离出常见革兰阴性杆菌3399株,主要为铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌、嗜麦芽寡养单胞菌和阴沟肠杆菌;大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)株检出率分别为28.0%和21.1%;肠杆菌科细菌对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、阿米卡星、美罗培南和亚胺培南的耐药率较低,细菌耐药率均<20.0%;头孢他啶和多黏菌素E对铜绿假单胞菌的抗菌作用强,耐药率分别为19.4%和0.4%;鲍氏不动杆菌对头孢哌酮/舒巴坦、亚胺培南和美罗培南的敏感率高,耐药率分别为11.1%、12.0%和15.6%;头孢哌酮/舒巴坦、磺胺甲噁唑/甲氧苄啶和米诺环素对嗜麦芽寡养单胞菌的抗菌活性最强,耐药率分别为5.7%、2.8%和0。结论临床分离的革兰阴性菌日益增多,对常用抗菌药物的耐药性增高,应重视耐药菌株的监测和药敏试验,临床医师应根据药敏试验结果,合理、个体化的选用抗菌药物。更多还原

【Abstract】 OBJECTIVE To investigate the distribution and resistance of Gram-negative bacilli,for guiding the rational use of antibiotics therapy.METHODS The identification was analyzed by ATB Expression automatic microbiology analytical instrument system.The Kirby-Bauer agar diffusion method was applied for the antibiotic susceptibility test and the results were read based on CLSI(2008) standards.RESULTS A total of 3399 pathogens strains were isolated,the most common pathogens of them were Pseudomonas aeruginosa,Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,Stenotrophomonas maltophilia,and Enterobacter cloacae.About 28.0% of E.coli isolates and 21.1% of K.pneumoniae isolates produced extended-spectrum β-lactamases(ESBLs).Under 20.0% of Enterobacteriaceae bacteria were resistant to piperacillin/tazobactam,cefoperazone/sulbactam,amikacin,meropenem and imipenem.Ceftazidime and colistin showed greater activity against P.aeruginosa,their resistant rates were 19.4% and 0.4%,respectively.About 11.1%,12.0% and 15.6% of A.baumannii were resistant to cefoperazone/sulbactam,imipenem and meropenem respectively.Under 20.0% of A.baumannii were resistant to cefoperazone/sulbactam,meropenem and imipenem.cefoperazone/sulbactam,trimethoprim/sulfamethoxazole and minocycline showed greater activity against S.maltophilia,their resistant rates were 5.7%,2.8% and 0,respectively.CONCLUSION The number of Gram-negative bacilli among clinical isolates as well as their antibiotic resistance are increasing.We should pay much attention to detecting drug-resistant strains and their antimicrobial susceptibility.Afterward,the antibiotics should beccsed reasonably and effectively according to test results of individual susceptibility.更多还原