2013年至2014年医院革兰阴性杆菌耐药监测情况分析

摘要

Objective Through the analysis of the hospital′s antimicrobial resistance monitoring situation, to provide reference for formu-lating reasonable and effective anti-infection treatment plans for clinicians. Methods The disc diffusion method ( K-B ) was used for the drug susceptibility test and clinical isolations of ESBLs test, according to the American association of clinical laboratory standardiza-tion CLSI2009-CLSI2012 ( M100 approximately-S19 ) standard for determining the susceptibility results of the hospital during 2013-2014. Results In the 472 isolated Gram-negative bacteria, Escherichia coli accounted for first place. The detection rates of Escherichia coli and Klebsiella ESBLS were 64. 41% and 34. 05% respectively. Enterobacteriaceae was highly sensitive to carbapenems, with a re-sistance rate of less than 1%, and its susceptibility rate less than 80% to other antimicrobial drugs;the sensitive rates of Pseudomonas aeruginosa to a variety of antibiotics were mostly below 70%; the sensitivity rate of Acinetobacter baumannii to various antibacterial drugs were more than 70%. Conclusion Escherichia coli infection is an important pathogen in the hospital. We should strengthen the monitoring of bacterial resistance for the development of rational and effective anti-infection treatment programs.%目的：通过对医院细菌耐药监测情况的分析，为临床医师制订合理、有效的抗感染治疗方案提供参考。方法采用纸片扩散法（K－B法）对医院2013年至2014年临床分离菌株进行药物敏感性试验(药敏试验)及超广谱β内酰胺酶( ESBLs )的检测，按美国临床实验室标准化协会CLSI2009－CLSI2012( M100－S19)年标准判定药物敏感性结果。结果在分离出的472株革兰阴性杆菌中，大肠埃希菌占首位。大肠埃希菌、克雷伯菌中ESBLs的检出率分别为64.41%和34.05%，肠杆菌科细菌对碳青霉烯类抗生素高度敏感，耐药率小于1%，对其他抗菌药物的敏感率低于80%，铜绿假单胞菌对各种抗菌药物的敏感率大多低于70%，鲍曼不动杆菌对各种抗菌药物敏感率大多低于70%。结论大肠埃希菌为医院肠杆菌科感染的重要致病菌。应加强监测细菌耐药性，为制订合理、有效抗感染治疗方案提供参考。