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目的了解蚌埠医学院第一附属医院2012-2014年常见革兰阴性菌耐药率的变移,为临床合理使用抗生素提供依据。方法药敏实验采用自动化仪器法或纸片扩散法。结果临床共分离出13 488株细菌,其中革兰阴性菌8 384株,排名前4位的是:大肠埃希菌40.4%(3 384/8 384)、肺炎克雷伯菌13.6%(1 138/8 384)、鲍曼不动杆菌10.4%(868/8 384)、铜绿假单胞菌9.0%(757/8 384),占分离革兰阴性菌的73.3%。大肠埃希菌、肺炎克雷伯菌产超广谱β-内酰胺酶菌株的检出率分别为67.8%和39.6%。肠杆菌科细菌(除粘质沙雷菌)对碳青霉烯类抗生素保持高度敏感性。鲍曼不动杆菌和铜绿假单胞菌对亚胺培南三年的耐药率分别大于77.1%和23.3%,广泛耐药鲍曼不动杆菌和铜绿假单胞菌的检出率为:84.8%和37.5%。结论该院临床分离的革兰阴性菌耐药情况严重,值得关注的是泛耐药及碳青霉烯类抗生素耐药菌株呈明显的逐年上升趋势,应引起高度重视。
Objective To understand the change of resistance rate of common Gram-negative bacteria in the First Affiliated Hospital of Bengbu Medical College from 2012 to 2014, and provide the basis for clinical rational use of antibiotics. Methods Drug susceptibility testing using automated instrumentation or disk diffusion method. Results A total of 13 488 strains of bacteria were isolated, of which 8 384 were Gram-negative bacteria. Among the top 4 strains, Escherichia coli 40.4% (3 384/8 384), Klebsiella pneumoniae 13.6% (1 138 / 8 384), Acinetobacter baumannii 10.4% (868/8 384) and Pseudomonas aeruginosa 9.0% (757/8 384), accounting for 73.3% of the isolates of Gram-negative bacteria. The detection rates of Escherichia coli and Klebsiella pneumoniae producing extended-spectrum β-lactamase strains were 67.8% and 39.6%, respectively. Enterobacteriaceae (other than Serratia marcescens) remain highly susceptible to carbapenem antibiotics. Acinetobacter baumannii and Pseudomonas aeruginosa three-year resistance rates to imipenem were greater than 77.1% and 23.3%, respectively, the detection rate of extensive drug-resistant Acinetobacter baumannii and Pseudomonas aeruginosa: 84.8% and 37.5%. Conclusions Gram-negative bacteria isolated clinically in this hospital are seriously drug-resistant. It is noteworthy that pan-drug-resistant and carbapenem-resistant strains show a clear upward trend year by year, which deserves great attention.