2012年江苏盛泽医院感染主要革兰阴性杆菌的分布及-南京医科大学.docVIP

2012年江苏盛泽医院主要革兰阴性杆菌的分布及耐药性监测张肖1蔡辉1顾兵2严佳斌1*颜承靖12 （1.江苏盛泽医院检验科，江苏 吴江 215228；2.南京医科大学第一附属医院检验学部，江苏 南京 210029） 摘要目的探讨2012年江苏盛泽医院感染患者中分离的革兰阴性杆菌的分布及耐药性，为治疗感染患者提供依据。方法收集2012年609例住院患者感染革兰阴性杆菌的相关资料进行分析，细菌鉴定采用API系统，细菌药物敏感性测定采用纸片扩散法。WHONET5.软件进行数据分析。结果2012年共检出革兰阴性杆菌609株，主要肺炎克雷伯菌（24.0%）、大肠埃希菌（21.7%）、铜绿假单胞菌（19.2%）、鲍曼不动杆菌（10.0%）和阴沟肠杆菌（6.4%）；耐药性分析结果显示，肠杆菌科细菌中肺炎克雷伯菌和大肠埃希菌产ESBLs的检出率为51.4%、58.3%；产ESBLs菌株对常用抗菌药物耐药率高于非产ESBLs菌株肠杆菌科细菌对碳青霉烯类抗菌药物高度敏感（%-100.0%）敏感性较高的抗菌药物有阿米卡星66.7%-98.6%）、米诺环素83.3%-88.0%）、头孢哌酮/舒巴坦83.3%-95.8%）、哌拉西林/他唑巴坦83.3%-92.8%）；非发酵菌属中铜绿假单胞菌和鲍曼不动杆菌对亚胺培南耐药率为69.2%、52.5%对抗菌药物敏感率50%。对抗菌药物的耐药率显著高于肠杆菌科细菌。结论我院检出的革兰阴性杆菌耐药情况较为严重，进行细菌耐药性监测有助于了解病原菌耐药性的变迁；同时临床应合理使用抗菌药物减缓新耐药株的产生。 关键词革兰氏阴性杆菌；细菌耐药性监测；抗菌药物 of Gram-negative bacilli distribution and resistance in Jiangsu Shengze Hospital in 2012 ZHANG Xiao1, CAI Hui1, GU Bing2, YAN Jia-bing1*, YAN cheng-jing1,2 （1. Department of Laboratory Medicine, Jiangsu Shengze Hospital, Jiangsu Wujiang 215228, China;2. Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China） [Abstract] OBJECTIVE：Investigate the distribution and drug resistance of gram negative bacilli which are isolated from patients in Jiangsu Shengze Hospital during 2012. Provide a basis for the treatment of infected patients. METHODS：Collect and analyze relevant information of 609 inpatients infected by gram negative bacilli in 2012. The bacteria were identified by API systems, bacterial drug sensitivity was determined by disk diffusion method. Whonet 5.6 software was used for data analysis. RESULTS：609 strains of gram negative bacilli were detected in 2012. Klebsiella pneumoniae（24.0%）, Escherichia coli （21.7%）, Pseudomonas aeruginosa（19.2%）, Acinetobacter baumannii（10.0%）and Enterobacter cloacae（6.4%）were the five major bacilli found. In view of the resistance, ESBLs were produced in 51.4% of Klebsiella pneumoniae and 58.3% of E.coli. The resistant rates of ESBLs producing strains were higher than those non-ESBLs-produ