某院临床标本中革兰阴性菌的分布及耐药性分析

目的了解痰液、尿液、全血标本中革兰阴性菌的分布及其耐药情况。方法应用WHONET5.4软件对住院患者所有痰液、尿液、全血标本分离的革兰阴性菌进行回顾性统计分析。结果痰标本中肺炎克雷伯菌最多,占26.06%,其次为大肠埃希菌和铜绿假单胞菌。尿液和全血标本中大肠埃希菌最多,分别占69.03%、54.41%,其次为肺炎克雷伯菌、奇异变形杆菌和铜绿假单胞菌;尿液中产超广谱β-内酰胺酶(ESBLs)菌检出率为52.7%,痰液检出率为40.8%,全血检出率最低,为38.8%。肠杆菌科细菌对头孢唑啉耐药性最高,为65.9%,对亚胺培南耐药性最低,为1.4%;非发酵菌对呋喃妥因耐药性最高,为90.6%,对厄他培南耐药性最低,为23.8%。结论三种标本分离的革兰阴性菌以肠杆菌科细菌为主;非发酵菌耐药性高于肠杆菌科细菌耐药性,尿液标本分离的肠杆菌科菌株的耐药性较另外两种标本分离菌株的耐药性高,痰标本分离的非发酵菌普遍较其他两种标本分离菌株的耐药性高;血标本分离出的革兰阴性菌较其他两种标本分离菌株的耐药性低。

Analysis on Gram-negative bacterial distribution from clinical specimens and drug resistance in a hospital

Objective To investigate the distribution and antimicrobial resistance of Gram-negative bacteria isolated from sputum,urine and blood.Methods The retrospective statistical analysis was carried out in Gram-negative bacteria isolated from sputum,urine and blood specimens in inpatients of our hospital and the data were analyzed with Whonet 5.4 software.Results The detection rate of Klebsiella pneumonia was highest,accounting for 26.06%,the second was Escherichia coli and the third was Pseudomonas aeruginosa in sputum specimens.In blood and urine specimens,Escherichia coli had the highest detection rate,accounting for 69.03% and 54.41% respectively,followed by Pneumonia crayresearch bacteria,singular proteus and pseudomonas aeruginosa.The detection rate of extended spectrum β lactamase（ESBL） producing bacteria was 52.7% in urine specimens,40.8% in sputum specimens and 38.8% in blood specimens.The drug resistantce rate of enterobacteriaceae was highest to cefazolin（65.9%） and lowest to imipenem（1.4%）.The drug resistantce rate of non-fermentative bacteria was highest to nitrofurantoin（90.6%） and lowest to Ertapenem（23.8%）.Conclusion Gram-positive bacteria isolated from 3 kinds of specimens are dominated by bacteria of enterobacteriaceae.Non-fermentative bacteria have higher dug resistance than bacteria of enterobacteriaceae.The drug resistantce rate of non-fermentative bacteria was higher than enterobacteriaceae.The drug resistantce of enterobacteriaceae bacteria isolated from urine is higher than that isolated from blood and sputum specimens.The drug resistantce of non-fermentative bacteria from sputum is higher than that isolated from urine and blood specimens.The drug resistantce of Gram-negative bacteria isolated from blood specimens is less than that isolated from the other two kinds of specimen.