我院临床标本中分离的革兰阴性杆菌菌种分布及耐药性分析

目的了解湖南省湘乡市中医院革兰阴性（G-）杆菌标本来源、菌种分布及耐药情况。方法收集2006年1月至2008年12月间临床各科送检标本做微生物病原学检测和药物敏感试验。结果共分离1190株G-杆菌,其中大肠埃希菌459株（38.57%）、铜绿假单胞菌214株（17.98%）、不动杆菌168株（14.12%）、肺炎克雷伯菌114株（9.58%）、阴沟肠杆菌104株（8.74%）、其他G-杆菌131株（11.01%）。其标本主要来源于痰液（54.78%）。所分离菌种对亚胺培南、阿米卡星、哌拉西林/他唑巴坦、头孢他啶、头孢噻肟、左氟沙星耐药率较低,依次为4.08%、20.28%、24.45%、33.65%、38.01%、40.19%。对氨苄西林耐药率最高,达94.31%。超广谱β-内酰胺酶检出率呈逐年上升趋势。结论G-杆菌分离自呼吸道,菌种分布以大肠埃希菌和铜绿假单胞菌为多,耐药菌株有逐年上升的趋势,需引起重视。

The analysis of distribution and resistance of gram -negative bacilli in the separation of our hospital's clinical specimens

Objective To study the source,distribution and antimicrobial resistance of gram-negative bacilli isolated in our hospital. Methods Pathogenic detection and antimicrobial sensitivity tests were performed for samples collected from clinical department from January 2006 to December 2008. Results 1190 gram-negative bacilli strains were isolated,459（38. 57% ）of which were Escherichia coli,168（14. 12% ） were Acinetobacter,214 （17. 98% ） were Pseudomonas aeruginosa,114 （9. 58% ） were Klebsiella pneumoniae,104 （8. 74%） were Escherichia cloacae,131 （11. 01%） were the rest of Gram-negative bacilli. ,most strains （54. 78%） were from sputum samples. The antimicrobial resistant rate of all the isolated bacterias to Imipenem,amikacin,pipracillin/Tazobactam,ceffazidime,Cefotaxima,levofloxacin was low,which was as follows：4. 08% ,20. 28% ,24. 45% ,33. 65% ,38. 01% and 40. 19% respectively. The resistant rate to ampicillin was 94. 31%. The isolation rate of ESBLs strains had an increasing tendence. Conclusion Gram-negative bacilli are mainly isolated from respiratory tract. The main isolated bacteria are Escherichia coli and Pseudomonas aeruginosa,the resistant bacteria strains are increasing every year.