临床标本革兰阴性杆菌的分布及药物敏感性研究

目的 分析医院临床分离革兰阴性(G-)杆菌的分布及药物敏感性, 指导临床使用抗生素.方法 回顾性分析医院2005年7月至2006年11月临床分离G-杆菌资料.结果 在分离出848株细菌中,检出G-杆菌共566株,阳性率为66.7%,G-杆菌前4种细菌依次是铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌和醋酸钙-鲍曼复合不动杆菌.15种抗生素的敏感率显示:亚胺培南的敏感率最高(大于87.7%),头孢曲松与头孢他啶分别为53.0%和78.8%以下.氨苄西林、氨苄西林/舒巴坦、头孢唑啉和复方新诺明对G-杆菌前4种细菌敏感率为43.2%以下,头孢曲松、呋喃妥因对铜绿假单胞菌敏感率小于4.0%,亚胺培南是治疗铜绿假单胞菌的特效抗生素,敏感率为87.7%,其耐药性有升高趋势.结论 铜绿假单胞菌是G-杆菌引起医院感染的首位病原菌,醋酸钙-鲍曼复合不动杆菌引起的感染稳步上升.近年来,细菌多重耐药性且耐药率有上升趋势,对第3代头孢菌素和亚胺培南的耐药性明显增强.临床应选用细菌培养敏感的抗生素,以减少细菌耐药性的产生,提高治疗效果.

Analysis on distribution of gram-negative bacilli isolated from clinical specimens and their drug sensitivity

Objective To investigate the distribution and drug sensitivity among gram-negative bacilli isolated from clinical specimens,and to provide guidance for clinical therapy.Methods The distribution and drug sensitivity of gram-negative bacilli isolated from clinical specimens were retrospectively analyzed.The strains were isolated from our hospital from July 2005 to Nov.2006.Results 848 strains of bacteria were isolated,out of which gram-negative bacilli(566 strains)accounted for 66.7%.The most predominant sensitive gram-negative bacillus in order was Pseudomonas aeruginosa,Escherichia coli,Klebsiellla pneumoniae and Acinietobacter calcoaceticus baumannii.Drug sensitivity test showed that sensitivity rate of imipenem was highest(>87.7%),of ceftriaxone and ceftazime was be- low 53.0% and 78.8% respectively.The sensitivity rates of ampicillin,ampicillin/sulbactam,cefazolin and trime- thoprim-sulfamethoxazole were below 43.2% to the four most sensitive gram-negative bacilli.The sensitivity rates of ceftriaxone and furadantin were below 4% to Pseudomonas aeruginosa.Imipenem is the first sensitive to Pseudo- monas aeruginosa,and its sensitivity rate was 87.7%.Its drug-resistance was likely to increase in recent years.Con- clusion Pseudomonas aeruginosa the first main pathogenic bacterium during nosocomial infections.The infection rate of Acinietobacter calcoaceticus has been increasing steadily.In recent years,bacteria drug resistance displays characteristic of multi-resistance,and the resistance rate tends to be increasing.The resistance to the third genera- tion cephalosporin and imipenem increases significantly.Rational use of antibiotics should be carried out according to drug sensitivity test results,and measures should be taken to reduce drug resistance.