阜外心血管医院5年G-致病菌的耐药监测

目的通过对该院2001-2005年临床分离的G^-杆菌致病菌流行病学分布及其耐药特征，为临床更合理应用抗生素提供部分的依据。方法采用纸片扩散法（K—B法）对该院住院患者中分离的902株革兰阴性杆菌进行药敏试验及ESBL的检测，并用WHONET5．3进行数据分析。结果902株革兰阴性杆菌中常见的菌种依次为铜绿假单胞菌（22．9％）、肺炎克雷伯菌（20．1％）、不动杆菌（17．4％）、嗜麦芽窄食单胞菌（11．6％）、大肠埃希菌（10．2％）和阴沟肠杆菌（9．8％）。大肠埃希菌ESBL的检出率为62％，肺炎克雷伯菌中ESBL的检出率为47．5％；肠杆菌科细菌未发现对碳青霉烯类耐药，铜绿假单胞菌和鲍曼不动杆菌亚胺配南的敏感率分别为68.3％和91.3％，阿米卡星对除嗜麦芽窄食单胞菌外的其他细菌的敏感率均较高，头孢哌酮／舒巴坦对治疗非发酵菌具有较广的抗菌谱和较高的敏感率。结论通过对细菌的耐药监测和分析了解不同医院各种细菌的耐药特点和趋势，可指导临床合理经验性用药。

Surveillance on antimicrobial resistance of gram-negative bacilli in cardiovascular hospital

Objective] To investigate the epidemic characteristics and drug resistance profile of clinical bacteria in our hospital. Methods] The susceptibility testing of clinical isolates in our hospital was performed and the ESBLs producing strains were detected using K-B method. The results were analyzed by WHONETS. Results] P. aemginosa was the most often detected pathogen in the 902 clinical gram-negative bacilli. The ESBLs producing strains in E.coli and K.pneumonia were 62% and 47.5% respectively. No resistance to carbarpenem was detected in Enterbacteriaceae. The sensitive rates of P.aemginosa and A.baumannii to Imipenem were 68.3% and 94.3% respectively. Amikacin had high sensitive rates in gram-negative bacilli except S.maltophilia. Cefoperazone/ Sulbactam was a good choice to treat the infection caused by nonferment/ng gram-negative bacilli. Conclusions] We should know the distribution and resistant character of the bacterium in cardiovascular hospital. The data will be useful for the early empiric administration of antimicrobial agent.