重症医学科革兰阴性菌耐药性分析

目的了解重症医学科临床分离革兰阴性菌及细菌耐药性情况。方法对某院重症医学科2009年10月～2011年9月的所有分离革兰阴性菌株进行耐药分析。结果共分离革兰阴性杆菌795株细菌,最常见的革兰阴性菌依次为铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌和鲍曼不动杆菌。铜绿假单胞菌对多种抗菌药物耐药,对丁胺卡那的敏感率最高(77.8%);对亚胺培南敏感率仅为41.4%。ESBL(+)肺炎克雷伯菌、大肠埃希菌耐药率明显升高,对亚胺培南敏感率分别为96.2%和100%。鲍曼不动杆菌呈现多重耐药,对亚胺培南敏感率为61.3%。结论重症医学科革兰阴性菌对抗菌药物耐药率高。细菌耐药性监测对指导临床经验性用药及抗菌药物管理具有重要意义。

Analysis on antimicrobial resistance of gram-negative bacteria in critical care medicine

OBJECTIVE To determine the resistance of gram-negative bacteria and germ of clinical isolates of intensive care unit.METHODS From October 2009 to September 2011,the drug-resistance of the isolates of gram-negative bacteria in our intensive care were analyzed.RESULTS Totally 795 pathogenic strains were isolated,in the common gram-negative bacteria,pseudomonas aeruginosa was the first,Klebsiella pneumoniae,Escherichia coli,and baumanii being the second,the third,and the fourth respectively.Pseudomonas aeruginosa bacteria had a variety of antimicrobial drug resistance,and was sensitive to Amikacin with the highest rate(77.8%);sensitive rate to Imipenem was only 41.4%.Drug resistance rates of ESBL(+)Klebsiella pneumoniae and Escherichia coli were significantly increased.The sensitive rate to Imipenem were 96.2%and 100% respectively.Baumanii presented multidrug resistance.The sensitive rate to Imipenem was 61.3%.CONCLUSION Antibiotic resistance of gram negative bacteria is high in Department of Critical Care Medicine.Bacterial resistance surveillance has significance in the clinical experience administration and antibacterial drug management.