2012年四川省彭州市人民医院常见肠杆菌科细菌药敏分析

摘要

目的 了解2012年四川省彭州市人民医院肠杆菌科抗菌药物治疗的效果,指导抗菌药物的临床应用.方法 常规方法分离培养临床病原菌；用自动化细菌鉴定仪鉴定细菌至菌种的水平；药敏试验方法按临床实验室标准化协会(clini-cal and laboratory standards institute,CLSI)规定的标准进行.用Whonet5.5系统软件进行数据统计分析.结果 共分离出肠杆 菌科细菌821株,其中肺炎克雷伯菌肺炎亚种309株,大肠埃菌242株,阴沟肠杆菌86株,产气肠杆菌40株,产酸克雷伯菌42株.敏感性最高的抗菌药物为碳青霉烯类,大肠埃希菌、肺炎克雷伯菌肺炎亚种、产酸克雷伯菌对头孢替坦均较敏感,敏感率分别为98.3％、98.3％和100％；而头孢吡肟对肺炎克雷伯菌肺炎亚种、产酸克雷伯菌、阴沟肠杆菌、产气肠杆菌的敏感率为92.2％、92.6％、97％和100％；超广谱β-内酰胺酶(extended-spectrum beta-lactamase,ESBL)阳性的肠杆菌科细菌,大肠埃希菌阳性率为59.5％、产酸克雷伯菌为16.7％、肺炎克雷伯菌肺炎亚种为14.63％.结论 碳青霉烯类仍是肠杆菌科细菌最敏感的药物,但已出现碳青霉烯类耐药,应引起重视.抗生素治疗应依据细菌学指导,选择敏感药物.%Objective To summarize the effect of enterobacteriaceaea antibacterial drug treatment during 2012 in our hospital in order to guide the clinical application of antibacterial drugs.Methods Routine methods of isolation and culture were performed and identification was carried out by using the automatic bacteria analysis system.Drug susceptibility test was performed according to CLSI (Clinical and Laboratory Standards Institute) standers.Date was statistically analyzed with the Whonet 5.5 software.Results A total of 821 isolates were collected in the hospital in which 37.6％ was Klebsiella pneumoniae,5.1％ Aci Clay Borrelia,29.5％ Escherichia coli,4.9％ Enterobacter aerogenes and 10.5％ Enterobacter cloacae.The most sensitive drug of Enterobacteriaceae was carbapenems.Escherichia coli,Klebsiella pneumoniae and Aci Clay Borrelia were sensitive to cefotetan,and the sensitive rates were 98.3％ 、98.3％、100％,respectively.Klebsiella pneumoniae,Aci Clay Borrel,Enterobacter cloacae and Enterobacter aerogenes were sensitive to cefepime,and the sensitive rates were 92.2％,92.6％,97％ and 100％,respectively.Extended-Spectrum Beta-Lactamase (ESBL)positive rate in Escherichia coli,Aci Clay Borrelia and Klebsiella pneumoniae were 59.5％,16.7％ and 14.63％,respectively.Conclusions Carbapenems remained very high activity against Enterobacteriaceae.However,the carbapenems resistance strains have been appeared that should pay attention.