2015年常见革兰阴性杆菌分布及耐药性分析

目的：分析该院常见革兰阴性杆菌分布特征及耐药性。方法回顾性分析该院2015年1～12月分离自门诊及住院患者标本的革兰阴性杆菌分布特征和耐药性。结果共分离病原菌3348株，革兰阴性杆菌2037株，占60．9％，其中构成比前5位依次为肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌、阴沟肠杆菌，构成比分别为26．1％、23．5％、16．5％、11．0％、7．2％。检出产超广谱β内酰胺酶（ESBLs）菌株266株，检出率为13．1％。5种革兰阴性杆菌对碳青霉烯类药物耐药率小于25．00％。肺炎克雷伯菌对氨苄西林和哌拉西林耐药较高，分别为97．18％、78．95％。大肠埃希菌对三代头孢的耐药率超过40．00％。大肠埃希菌对氟喹诺酮类耐药超过30．00％，其他革兰阴性杆菌对氟喹诺酮类耐药率较低，为4．70％～23．35％。鲍曼不动杆菌对抗菌药物较敏感，对各种药物的耐药率小于30．00％。铜绿假单胞菌对头孢曲松、头孢噻肟耐药率较高，分别为62．39％、50．44％。阴沟肠杆菌对阿莫西林／克拉维酸钾、头孢唑林的耐药率较高，分别为98．63％和97．95％。结论革兰阴性杆菌是的主要病原菌，多重耐药性问题日益严重，应加强抗菌药物合理使用，减少多重耐药菌的产生。

Distribution and drug resistance of gram negative bacilli in 2015

Objective To analyze the distribution and drug resistance of gram negative bacilli(GNB) .Methods Distribution and drug resistance of GNB ,isolated from clinic and hospitalized patients ,were retrospectively analyzed .Results A total of 3 348 strains of pathogenic bacteria were isolated ,including 2 037 strains of GNB ,accounting for 60 .9% .The constituent ratios of the most common GNB were 26 .1% of Klebsiella pneumonia ,23 .5% of Escherichia coli ,16 .5% of Acinetobacter baumannii ,11 .0% of Pseudomonas aeruginosa and 7 .2% of Enterobacter cloacae .266 stains ,producing extended‐spectrum β‐lactamases(ESBLs) were detected ,and the detection rate was 13 .1% .Resistant rates of the five common GBN to carbopenems were less than 25 .00% .Re‐sistant rates of Klebsiella pneumonia to ampicillin and piperacillin were relatively high ,which were 97 .18% and 78 .95% .Resistant rate of Escherichia coli to the third generation of cephalosporin were higher than 40 .00% .Resistant rate of Escherichia coli to quin‐olones were higher than 30 .00% ,and those of the other GNB were 4 .70% -23 .35% .Acinetobacter baumannii were sensitive to antibacterials ,with resistant rates less than 30 .00% .Resistant rates of Pseudomonas aeruginosa to ceftriaxone and cefotaxim were relatively high ,which were 62 .39% and 50 .44% .Resistant rates of Enterobacter cloacae to amoxicillin/potassium clavulanate and ceftriaxone and cefazolin were relatively high ,which were 98 .63% and 97 .95% .Conclusion GNB could be the most common path‐ogenic bacteria .Antibacterials should be rationally used to avoid the generation of multi‐drug resistant strains .