2011-2013年奇异变形杆菌临床分离株的耐药性分析

目的了解近三年来奇异变形杆菌(Proteus mirabilis)的临床分布和产ESBLs菌株的检出率,并分析其耐药情况,为临床合理用药提供参考。方法收集广州医科大学附属第二医院2011年1月至2013年12月间临床分离的193株奇异变形杆菌抗菌药物敏感性的检测结果 ,运用WHONET 5.4软件进行统计分析。结果分离的奇异变形杆菌主要分布在尿液(39.90%)和痰(11.40%)中,以及脓液(5.18%)、血液(1.5%)、胆汁(0.52%)和其他(40.93%,如伤口分泌物、宫颈分泌物、导管等)。2011-2013年奇异变形杆菌的ESBLs确证试验阳性率分别为9.30%、22.97%、28.95%,对奇异变形杆菌ESBLs阳性株耐药率较低的抗生素及其耐药率分别为:美罗培南(0.0%),亚胺培南(0.0%),替卡西林/克拉维酸(0.0%),头孢哌酮/舒巴坦(2.5%),哌拉西林/他唑巴坦(5.0%),头孢西丁(7.5%),丁胺卡那(15.0%)。结论奇异变形杆菌中产ESBLs菌株检出率较高,耐药性严重,应加强奇异变形杆菌的分离鉴定及耐药性的监控,有针对性地合理使用抗生素,避免耐药情况进一步加剧。

Drug resistance analysis of Proteus mirabilis clinical isolates from the year 2011 to 2013

Objective To investigate the clinical distribution, the prevalence of ESBLs and antibiotic resistance of Proteus mirabilis isolated during the year of 2011-2013, and provide some clues for clinical therapy of Proteus mirabilis （P. mirabilis ）. Methods The antibiotic susceptibility results of P. mirabilis which isolated from our hospital during January 2011 to December 2013 were collected and analyzed by using WHONET 5.4 statistical software. Results Most of the clinical isolatescame from urine and sputum specimens（39.90% and 11.40%）; followed by pus （5.18%）, blood（1.5%）, and other types of specimen. In 2011-2013, the ESBLs test positive rates of P.mirabilis were 9.30%, 22.97% and 28.95%, respectively. This shows a rising trend of ESBLs positive P..mirabilis year by year. P.mirabilis was more sensitive to the following antibiotics： Meropenem （0.0%） ,Imipenem （0.0%）, Ticarcillin/Clavulanic acid （0.0%）, Cefoperazone/Sulbactam （2.5%）, Piperacillin/Tazobactam（5.0%）, Cefoxitin（7.5%）, Amikacin（15.0%）. Conclusions The ESBLs positive rate is high in P.mirabilis clinical isolates. The antibiotic resistance situation is also serious for this bacterial strain. It is important to strengthen the separation, identification and antibiotic resistance testing of P.mirabilis, which would provide helpful information for P. mirabilis infection therapy.