摘要
目的了解重症监护病房(ICU)常见革兰阴性杆菌的分布及耐药性情况,为临床治疗提供依据。方法用WalkAway96PLUS自动化微生物鉴定仪进行菌株鉴定,用微量稀释法和K-B法检测ICU主要革兰阴性杆菌的耐药率并对各种细菌的分布进行分析。结果 2010年6月至2011年5月本院ICU病房共分离1329株细菌,其中革兰阴性杆菌分离率前5位的依次为铜绿假单胞菌263株(19.8%)、鲍曼不动杆菌204株(15.3%)、肺炎克雷伯菌166株(12.5%)、嗜麦芽寡养单胞菌69株(5.2%)、大肠埃希菌58株(4.4%)。大肠埃希菌主要从痰液(34.5%)、血液(31.0%)和尿液(27.6%)中检出;其余细菌主要从痰液(86.7%～92.8%)中检出。肺炎克雷伯菌和大肠埃希菌对亚胺培南的耐药率分别为2.4%和0;对哌拉西林/他唑巴坦的耐药率分别为14.5%和15.5%;对左氧氟沙星、环丙沙星、阿米卡星、头孢吡肟、头孢他啶、庆大霉素、妥布霉素、头孢噻肟、氨曲南、复方新诺明、阿莫西林/棒酸和头孢西丁等的耐药率为19%～100%。非发酵革兰阴性杆菌中,铜绿假单胞菌和鲍曼不动杆菌对阿米卡星、左氧氟沙星、环丙沙星、头孢吡肟、头孢他啶、庆大霉素、妥布霉素、亚胺培南、头孢噻肟、复方新诺明和哌拉西林/他唑巴坦的耐药率为44.9%～100%;嗜麦芽寡养单胞菌对复方新诺明和左氧氟沙星的耐药率分别为10.1%和8.7%。结论应动态监测ICU常见革兰阴性杆菌的耐药性及分布,临床上应根据不同种细菌的耐药特点合理选用抗菌药物,预防耐药菌株的传播流行。
Objectives To investigate drug resistance and distribution of Gram-negative bacilli in intensive care units（ICU） in our hospital, in order to provide guidance for clinical treatment. Methods WalkAway 96 PLUS automated microbial identification system was used for bacterial identification. Drug resistance and distribution of collected Gram-negative bacilli in ICU were analyzed by Microdilution method and K-B method. Results Total of 1329 strains of Gram-negative bacilli were collected from ICU in our hospital during June 2010 to April 2011, in which the top five of isolation rates were Pseudomonas aeruginosa （263 strains, 19. 8% ）, Acinetobacter baumannii （204 strains, 15. 3% ）, Klebsiella pneumoniae （ 166 strains, 12.5% ）, Stenotrophomonas maltophilia （ 69 strains, 5.2% ） , and Eseheriehia eoli （ 58 strains, 4.4% ）. Eseheriehia eoli were mainly eolleeted from sputum （34. 5% ）, blood （31. 0% ） and urine （27.6%）. The other baeteria were mainly eolleeted from sputum （86.7%-92.8%）. Resistanec rates of Klebsiella pneurnoniae and Escherichia coli to imipenem were 2.4% and 0, and 14. 5% and 15.5% to piperacillin/tazobaetam; and 19%-100% to levofloxaein, eiprofloxaein, amikacin, cefepime, eidomyein, tobramyein, eefotaxime, aztreonam, SMZ-TMP, amoxieillin/elavulanie, eefoxitin, eefazolin and ampieillin. In non-fermenting gram-negative bacteria, resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to amikacin, levofloxacin, ciprofloxacin, cefepime, ceftazidime, cidomycin, tobramycin, imipenem, cefotaxime, SMZ-TMP and piperacillin/tazobactam were 44. 9%-100%. Resistance rates of Stenotrophomonas maltophilia to SMZ-TMP and levofloxacin were 10. 1% and 8. 7%, respectively. Conclusions Resistance of Gram-negative bacilli collected from ICU should be monitored dynamicly inhospital. Antibiotics should be chosen according to drug sensitivity test in clinical practice to prevent the spread of epidemic resistant strains.
出处
《中华实验和临床感染病杂志（电子版）》
CAS
2012年第1期39-42,共4页
Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition)
关键词
重症监护病房
革兰阴性菌
抗菌药物
耐药性
Intensive care unit
Gram-negative bacteria
Anti-bacterial agents
Drug resistance
