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目的了解我院临床分离革兰阴性杆菌分布特征及对常用抗菌药物的耐药情况,为指导临床用药提供依据。方法收集2014年龙潭医院门诊及住院患者分离的革兰阴性杆菌,剔除同一患者相同部位分离的重复菌株,共得772株。采用微量稀释法或K-B法进行药物敏感性试验,结果按CLSI 2013版标准判读。结果所得革兰阴性杆菌772株,前4位的是铜绿假单胞菌(28.4%)、肺炎克雷伯菌(28.1%)、大肠埃希菌(18.7%)及鲍曼不动杆菌(11.3%)。大肠埃希菌对头孢呋辛、复方新诺明及喹诺酮类耐药率大于70%,肺炎克雷伯菌对哌拉西林耐药率大于65%,非发酵菌耐药率总体低于肠杆菌科。阿米卡星和碳青霉烯类对大部分革兰阴性杆菌均有较高活性。结论我院革兰阴性杆菌耐药情况严峻,应加强耐药性监测,合理使用抗菌药物。
Objective To understand the clinical characteristics of Gram-negative bacilli isolated from our hospital and their resistance to commonly used antibacterials, so as to provide the basis for clinical application. Methods Gram-negative bacilli isolated from outpatients and inpatients of Longtan Hospital in 2014 were collected, and 772 isolates were isolated from the same patient in the same patient. Drug susceptibility testing using the microdilution method or the K-B method was interpreted according to the CLSI 2013 version. Results The 772 strains of Gram-negative bacilli were obtained. The first four strains were Pseudomonas aeruginosa (28.4%), Klebsiella pneumoniae (28.1%), Escherichia coli (18.7%) and Acinetobacter baumannii %). Escherichia coli to cefuroxime, cotrimoxazole and quinolone resistance rate greater than 70%, Klebsiella pneumoniae to piperacillin resistance rate greater than 65%, non-fermentative bacteria resistance rate overall lower than Enterobacteriaceae Section. Amikacin and carbapenems are highly active against most Gram-negative bacilli. Conclusion Gram-negative bacilli in our hospital have a serious drug resistance situation. Drug resistance monitoring should be strengthened and antibacterial drugs should be used reasonably.