某医院常见革兰阴性杆菌的分布与药敏分析

目的 了解珠海市人民医院2009~2010年住院患者常见的菌群分布及其耐药性,为细菌性感染的诊治提供参考依据.方法 用生物梅里埃公司的ATB鉴定系统进行菌种鉴定和药敏试验,用ATBPLUS VER3.0软件统计分析结果.结果 2009~2010年共分离出革兰阴性杆菌3 032株,其中铜绿假单胞菌占29.55%,肺炎克雷伯菌占33.44%,大肠埃希菌占27.51%,阴沟肠杆菌占5.80%,其他革兰阴性杆菌占3.70%.铜绿假单胞菌耐药率高于60%的抗菌药物有头孢噻吩、头孢噻肟、头孢西丁.肺炎克雷伯菌对美罗培南、亚胺培南、头孢吡肟、阿米卡星菌、妥布霉素、哌拉西林/三唑巴坦敏感.大肠埃希菌对第三代头孢菌素、氟喹诺酮类的耐药率增高,对亚胺培南、美罗培南、阿米卡星敏感,对哌拉西林/三唑巴坦、头孢他啶及奈替米星较敏感.阴沟肠杆菌呈多重耐药.结论 该地区常见革兰阴性杆菌的构成比及耐药率和国内其他地区有一定的差异,且细菌多重耐药情况更为严重.

Distribution and drug susceptibility analysis of common Gram-negative bacilli in certain area

Objective To understand the bacterial flora distribution and drug resistance of common clinical strains from 2009to 2010in Zhuhai People’s Hospital to provide references for the diagnosis and treatment of bacterial infection.Methods The ATB identification system was used for the identification and resistance analysis of clinical strains.ATBPLUS Ver3.3software package was used for data analysis.Results In the 3 032strains of gram-negative bacillus(G bacilli) for 2009-2010,Pseudomonas aeruginosa accounted for 29.55%,Klebsiella pneumoniae accounted for 33.44%,Escherichia coli accounted for 27.51%,Enterobacter cloacae accounted for 5.80%and other G bacilli accounted for 3.70%.Drug susceptibility test showed that Pseudomonas aeruginosa were with resistant rate more than 60% to antibacterial drugs,such as cefalotin,cefotaxime and cefoxitin.Klebsiella pneumoniae was sensitive to meropenem,cefepime,imipenem,amikacin,tobramycin and piperacillin /tazobactam.The drug resistance of the Escherichia coli to the third-generation cephalosporins and fluoroquinolone was increased.Escherichia coli was sensitive to impenem,meropenem,amikacin,and more sensitive to piperacillin /tazobactam,ceftazidime and netilmicin.Enterobacter cloacae was with multi-drug resistance.Conclusion The constituent ratio and drug resistance rate of the common pathogenic bacteria in this area might be different with other regions,and might be with more serious multi-drug resistance.