2010—2013年广西壮族自治区脑科医院革兰阴性菌的分布与耐药性分析.PDF

现代药物与临床 Drugs Clinic 第 29 卷 第 5 期 2014 年 5 月 ·547 · 2010—2013 年广西壮族自治区脑科医院革兰阴性菌的分布与耐药性分析 苏文生 广西壮族自治区脑科医院，广西 柳州 545005 摘 要：目的 了解广西壮族自治区脑科医院临床常见革兰阴性菌的分布及耐药性变迁，为指导临床合理使用抗菌药物提供 可靠依据。方法 回顾性分析 2010—2013 年广西壮族自治区脑科医院临床各科室送检标本分离的革兰阴性菌及其耐药性进 行回顾性调查分析。结果 4 年间送检标本共分离出 7 450 株病原菌，主要以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、 鲍曼不动杆菌和阴沟肠杆菌为主，检出率依次为 28.4 %、20.9% 、18.7%、15.2%、6.2% 。4 年间大肠埃希菌和肺炎克雷伯菌 超广谱 β- 内酰胺酶（ESBLs ）的平均检出率分别为 56.3%、36.9% 。药敏结果显示，不同菌属对抗生素的耐药率有差别，肺 炎克雷伯菌、大肠埃希菌和阴沟肠杆菌对碳青霉烯类抗菌药物总体上有较高的敏感性；铜绿假单胞菌对喹诺酮类、亚胺培南、 头孢哌酮/舒巴坦耐药率相对较低；鲍曼不动杆菌对多数抗菌药物高度耐药，且呈逐年上升趋势。结论 广西壮族自治区脑 科医院临床常见革兰阴性菌对常用抗菌药物耐药严重，应加强革兰阴性菌耐药性的动态监测，以指导临床进行合理规范的抗 感染治疗。 关键词：抗菌药物；抗药性；微生物敏感性试验；革兰阴性杆菌 中图分类号：R978.7 文献标志码：A 文章编号：1674 - 5515(2014)05 - 0547 - 05 DOI:10.7501/j.issn.1674-5515.2014.05.023 Clinical analysis of Gram-negative bacteria distribution and drug resistance in Brain Hospital of Guangxi Zhuang Autonomous Region from 2010 to 2013 SU Wen-sheng Brain Hospital of Guangxi Zhuang Autonomous Region, Liuzhou 545005, China. Abstract: Objective To investigate the distribution and antimicrobial resistance of common Gram-negative bacteria in Brain Hospital of Guangxi Zhuang Autonomous Region during 2010 to 2013, and to instruct the reasonable clinical application of antibiotics. Methods The clinical data and drug resistance of Gram-negative bacteria isolated from various clinical specimens from 2010 to 2013 were reviewed retrospectively. Results All of 7 450 Gram-negative bacteria were isolated, and the main strains were Escherichia coli (28.4 %), Klebsiella pneumoniae (20.9%), Pseudomonas aeruginosa (18.7%), Acinetobacter baumannii (15.2%), and Enterobacter cloacae (6.2%). The extended spectrum β-lactamases (ESBLs) of E. coli and K. pneumoniae were 56.3% and 36.9%, respectively. The rates of sensitive to antimicrobial agents were different between bacteria. K. pneumoniae, E. coli,