医院常见革兰阴性菌的临床分布及耐药性分析

发布时间：2018-05-30 14:28

本文选题：革兰阴性菌 + 耐药率　；参考：《中国医院药学杂志》2016年06期

【摘要】：目的:通过分析某院常见革兰阴性菌的临床分布及耐药性现状,为临床治疗革兰阴性菌感染选择合理的抗菌药物提供参考依据。方法:收集2012-2014年某院临床科室送检的标本进行检测,采用法国生物梅里埃公司的VITEK-2 Compact全自动细菌鉴定仪进行进行细菌培养与鉴定及药敏试验,采用WHONET5.5对病原菌的临床分布以及其耐药率进行分析。结果:医院3年内共分离出革兰阴性菌株9 230株,前四位分别是大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌,分别占35.8%,18.4%,17.9%,11.0%。其中大肠埃希菌对氨苄西林耐药率高达90.1%。对头孢唑林、头孢曲松、环丙沙星和复方磺胺甲叮恶唑的耐药率均大于60%。肺炎克雷伯菌对头孢类和喹诺酮类的耐药性较高,对碳青霉烯类、阿米卡星、头孢替坦或头孢西丁、头孢哌酮钠舒巴坦钠均较敏感,耐药率均小于10%。鲍曼不动杆菌对阿米卡星、氨曲南、头孢哌酮钠舒巴坦钠和氨苄西林钠舒巴坦钠的耐药率均较低,分别为6.9%,9.9%,8.2%和10.8%,但对亚胺培南等其他常见抗菌药物的耐药率较高。铜绿假单胞菌对常见抗菌药物的耐药率为5.9%~19.2%。结论:医院必须加强对常见革兰阴性菌耐药率的动态性监测,根据药敏试验结果合理选用抗菌药物,以实施个体化给药方案,降低细菌耐药率和减缓多重耐药菌的产生。
[Abstract]:Objective: to analyze the clinical distribution and drug resistance of common Gram-negative bacteria in a hospital, and to provide a reference for the clinical treatment of Gram-negative bacteria infection. Methods: the specimens collected from clinical department of a certain hospital from 2012 to 2014 were collected for detection. The bacterial culture, identification and drug sensitivity test were carried out by VITEK-2 Compact automatic bacteria identification instrument of French Bio-Meridier Company. The clinical distribution and drug resistance rate of pathogenic bacteria were analyzed by WHONET5.5. Results: a total of 9 230 Gram-negative strains were isolated in the hospital within 3 years. The first four strains were Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii, accounting for 35.818. 4% and 17. 9% of them, respectively. The first four were Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii, respectively. The resistance rate of Escherichia coli to ampicillin was 90.1%. The resistance rates of cefazolin, ceftriaxone, ciprofloxacin and compound sulfamethoxazole were higher than 60%. Klebsiella pneumoniae showed higher resistance to cefosporins and quinolones, and were sensitive to carbapenems, amikacin, ceftitan or cefoxetine, and cefoperazone sodium sulbactam. The resistance rates of Acinetobacter baumannii to amikacin, aztreonam, cefoperazone sodium sulbactam sodium and ampicillin sodium sulbactam sodium were all low, which were 6.9% and 10.8%, respectively, but the resistance rate to other common antimicrobial agents such as imipenem was higher. The resistance rate of Pseudomonas aeruginosa to common antimicrobial agents was 5.9% and 19.2% respectively. Conclusion: the hospital must strengthen the dynamic monitoring of the resistance rate of common Gram-negative bacteria, select antibiotics reasonably according to the results of drug sensitivity test, so as to carry out individualized administration plan, reduce the rate of bacterial resistance and slow down the production of multi-drug resistant bacteria.
【作者单位】：玉林市第一人民医院药学部;玉林市妇幼保健院药剂科;玉林市第一人民医院检验科;
【分类号】：R446.5

【相似文献】