摘要
目的了解肠杆菌科细菌的临床分布及耐药性,为临床合理用药提供依据。方法收集常规培养检出的3 467株肠杆菌科细菌,采用细菌全自动鉴定/药敏分析仪进行细菌鉴定及微生物敏感性试验。结果检出3 467株肠杆菌科细菌,标本分布主要以尿液(33.5%)为主;其次为痰(29.4%)、血液(12.1%)、脓液(9.8%),科室分布主要为泌尿外科病房(11.4%),其次为ICU病房(9.8%),分离的肠杆菌科细菌中主要为埃希菌属(42.8%)和克雷伯菌属(34.8%),埃希菌属和克雷伯菌属产超广谱β-内酰胺酶(ESBLs)阳性率分别为61.5%和35.9%,肠杆菌科细菌微生物敏感性试验总体耐药率较高,对氨苄西林(89.8%)和头孢唑林(94.9%)耐药率最高,其次为哌拉西林(57.0%)和四环素(55.1%),对复方新诺明、环丙沙星、头孢噻肟、氨苄西林/舒巴坦耐药率在40%~50%,对阿米卡星(4.1%)、哌拉西林/他唑巴坦(8.9%)、亚胺培南(3.1%)、美罗培南(2.0%)耐药率较低,产超广谱β-内酰胺酶(50.5%)和产碳青霉烯酶(3.1%)的肠杆菌科细菌耐药率更高,并呈现多重耐药。结论我院肠杆菌科细菌主要引起泌尿系和下呼吸道感染,总体耐药现象日趋严重,尤其是产超广谱β-内酰胺酶和产碳青霉烯酶的肠杆菌科,细菌的耐药性监测对临床合理使用抗菌药有着重要指导意义,加大控制抗菌药合理应用的力度,以减少耐药株的上升。
Objective To investigate the clinical distribution and drug resistance of enterobacteriaceae bacteria in our hospital in order to provide basis for clinical rational use of drug. Methods A total of 3467 strains of enterobacteriaceae bacteria isolated by means of conventional cultured in our hospital were collected,BD PHOENIX100 automatic bacteria identification and drug susceptibility analyzer were used to identify bacteria and analyze the antimicrobial susceptibility.Results Among the 3467 strains of enterobacteriaceae bacteria,which were mainly distributed in urine（ 33. 5%）,followed by sputum（ 29. 4%）,blood（ 12. 1%）,pus（ 9. 8%）,which were mainly distributed in department of urology ward（ 11. 4%）,followed by ICU ward（ 9. 8%）. Of the 3467 strains of enterobacteriaceae bacteria,which were mainly Escherichia spp（ 42. 8%） and Klebsiella spp（ 34. 8%）,and the positive rates of Escherichia spp and Klebsiella spp producing extended spectrum beta lactamases（ ESBLs） were 61. 5% and 35. 9%,respectively. Enterobacteriaceae microbial sensitivity tests showed that the total drug resistance rates were the highest to ampicillin（ 89. 8%） and cefazolin（ 94. 9%）,followed by piperacillin（ 57. 0%） and tetracycline（ 55. 1%）,which were between 40% ~ 50% to cotrimoxazole,ciprofloxacin,cefotaxime,ampicillin/sulbactam,and the drug resistance rate was lower to Amikacin（ 4. 1%）, piperacillin/tazobactam（ 8. 9%）,imipenem（ 3. 1%）,meropenem（ 2. 0%）. The drug resistance rates were higher in ESBLs-producing enterobacteriaceae bacteria（ 50. 5%） and carbapenemase-producing enterobacteriaceae bacteria（ 3. 1%）,which showed multiple drug resistance.Conclusion In our hospital,enterobacteriaceae bacteria mainly cause urinary tract infection and lower respiratory tract infection,the total drug resistance is becoming more and more serious. The drug resistance rates of the ESBLs-producing enterobacteriaceae bacteria and carbapenemases-producing enterobacteriaceae bacteria are more
出处
《河北医药》
CAS
2018年第3期456-461,共6页
Hebei Medical Journal
关键词
肠杆菌科
微生物敏感性试验
抗药性
细菌
回顾性研究
enterobacteriaceae
microbial sensitivity tests
drug resistance
bacteria
retrospective study
