心血管病医院院内感染革兰阴性杆菌分布及常见菌耐药性分析

[目的]了解心血管病医院革兰阴性杆菌的分布及常见菌的耐药性，为临床合理用药提供依据。[方法]对我院2001～2004年内外科所有病房分离的革兰阴性杆菌进行分类，用微量肉汤稀释法对常见菌进行耐药性分析。[结果]我院分离的革兰阴性杆菌以鲍曼不动杆菌，铜绿假单胞菌，肺炎克雷伯菌，大肠埃希菌及嗜麦芽窄食单胞菌为主，与相关报道相似。其中肺炎克雷伯菌产ESBL的菌株占49.3％，大肠埃希菌产ESBL的菌株占67.0％，总产酶率为55.4％，高于相关报道。亚胺培南仍是治疗肠杆菌科的最有效的抗生素；非发酵菌中除嗜麦芽窄食单胞菌对抗生素多重耐药外，铜绿假单胞菌及鲍曼不动杆菌对氨基糖甙类，多种头孢菌素及加酶抑制剂的抗生素呈现敏感，但出现耐亚胺培南的铜绿假单胞菌及鲍曼不动杆菌。[结论]根据药敏结果，合理选择抗生素，对预防耐药菌的产生具有极其重要的意义。

Analysis of drug resistance and distribution of Gram - negative bacilli in cardiovascular hospital

[Objective] To analyze the distribution and drug resistance of Gram - negative bacilli in a cardiovascular hospital to provide basis for clinical treatment. [ Methods] The clinical isolates of Gram - negative bacilli collected from January 2001 to December 2004 in our hospital were classified and their susceptibility to antibiotics was tested by MIC method. [ Results] The Gram - negative bacilli in our hospital mainly included K. pneumoniae, E. coli, X. maltophilia, P. aeruginosa and Acinetobacter baumannii. The ESBL-producing rate was 49.3% for K. pneumoniae and 67.0% for E. coli. Impenem is the most efficient drug for treatment of their infection. Impenem - resistant P. aeruginosa and Acinetobacter baumannii were isolated. [ Conclusion ] Reasonable use of antibiotics based on drug sensitive test is important for prevention of appearance of drug - resistant strains of bacilli.