摘要
目的分析本地区某医院2013-2016年革兰阴性杆菌的分布及其对抗生素的耐药性,指导临床合理应用抗生素。方法收集2013-2016年本院临床革兰阴杆菌4 091株,采用VITEK-Compact2对临床分离菌株鉴定与药敏试验(MIC法)),按CLSI 2012年标准判断结果,WHONET 5.6软件统计分析。结果临床分离革兰阴性杆菌4 091株,标本来源主要是呼吸道分泌物、尿液和伤口拭子;其中肠杆菌科细菌比率较高(占62.04%),铜绿假单胞菌和鲍曼不动杆菌分别占19.09%和11.05%。大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌产ESBLs依次为52.5%、46.7%和20.2%;肠杆菌对哌拉西林/他唑巴坦和亚胺培南耐药率低(<3%),且明显低于头孢吡肟、头孢他啶、氨曲南和头孢曲松,铜绿假单胞菌和鲍曼不动杆菌对亚胺培南耐药率高(分别为20.8%和62.7%)。大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌出现少量泛耐药菌株,碳青霉烯类耐药铜绿假单胞菌和碳青霉烯类耐药鲍曼不动杆菌对阿米卡星敏感率高。结论革兰阴性杆菌耐药性增加对临床感染治疗构成严重威胁,多重耐药菌和耐碳青霉烯类革兰阴性杆菌增多,应加强本地区耐药性监测和控制措施,按照药敏结果合理使用抗生素。
Objective To analyze the distribution of gram-negative bacilli（G-b）and antibacterial drug resistance in a hospital of Shenzhen during 2013-2016. Methods The gram-negative bacilli were isolated and the antibacterial susceptibility testing was conducted by VITEK-Compact2（minimal inhibitory concentration,MIC）. Data were analyzed according to CLSI 2012 with WHONET 5.6 software. Results The rate of G-benterobacteriaceae was high（62.04%）. Pseudomonas aeruginosa and Acinetobacter baumannii accounted for 19.09% and 11.05%,respectively. The ESBLs producing Escherichia coli,Klebsiella pneumoniae and Proteus mirabilis were 52.5%,46.7% and 20.2%,respectively. Enterobacteriaceae have low resistance to piperacillin/tazobactam and imipenem（less than 3%）and are significantly lower than cefepime,ceftazidime,aztreonam and ceftriaxone. The resistance rates of P. aeruginosa and A. baumannii to imipenem were high（20.8% and 62.7%,respectively）. Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumannii,and Pseudomonas aeruginosa had a few pandemic resistant strains（PDR）. Carbapenem-resistant Pseudomonas aeruginosa（CRPA） and carbapenem-resistant Acinetobacter baumannii（CRAB）were highly sensitive to amikacin. Conclusion Increased resistance of G-bposes a serious threat to the treatment of clinical infections. Multidrug-resistant（MDR）and carbapenem-resistant（CR）gram-negative bacilli are increasing,and sufficient attention should be paid to strengthening the monitoring and control of drug resistance in the region. Antibiotics should be used according to the results of drug susceptibility.
作者
刘镜光
刘典浪
高丹
陈凤平
LIU Jing-guang;LIU Dian-lang;GAO Dan;CHEN Feng-ping(Department of Clinical Lab, Shenzhen Fuyong People＇s Hospital , Shenzhen, Guangdong 518103;Department of Clinical Test Center, the First Affiliated Hospital of Jinan University, Guangzhou, Guangdong 510630, China)
出处
《热带医学杂志》
CAS
2018年第5期642-645,共4页
Journal of Tropical Medicine
关键词
细菌耐药性
产超广谱Β-内酰胺酶
耐碳青霉烯类肠杆菌
革兰阴性杆菌
Bacterial resistance
Extended Spectyum β-Lactamase
Carbapenem-resistant Entreobacteriaceae
Gram negative bacilli
