枸橼酸杆菌医院感染特点及耐药性检测

目的了解枸橼酸杆菌在医院感染中的分布特点及耐药特性,为临床抗感染治疗提供依据。方法细菌分离培养按《全国临床检验操作规程》进行;采用WalkAway-40全自动细菌鉴定仪对临床分离菌株进行菌种鉴定;采用K-B法进行药敏试验,用WHONET5.4软件进行统计分析。结果共分离枸橼酸杆菌属细菌172株,其中弗劳地枸橼酸杆菌最多,占70.3%,其次为丙二酸盐阴性枸橼酸杆菌和异型枸橼酸杆菌,分别占14.0%和5.2%,172株枸橼酸杆菌的感染部位以呼吸道最多（67.4%）,其次为泌尿生殖道（22.1%）;病区分布主要为神经内科病房、呼吸内科病房、肾内科病房和肿瘤病房,分别占29.1%、27.9%、16.9%和11.0%;药敏结果显示,172株枸橼酸杆菌对氨苄西林、头孢唑啉、头孢西丁的耐药率较高,均大于87%,对阿米卡星、亚胺培南、舒普深的耐药率较低,均小于20%。结论医院感染的枸橼酸杆菌以弗劳地枸橼酸杆菌最多见,主要来自呼吸道标本,枸橼酸杆菌已呈现出多重耐药现象,亚胺培南、舒普深、阿米卡星等对其具有良好的抗菌活性。

Nosocomial infection and antibiotic resistance surveillance of citrobacter

Objective To investigate the distribution and antibiotic resistance of citrobacter for anti-infection therapy.Methods The citrobacter were identified by Walk-Away-40 according to《National Guide to Clinical Laboratory Procedures》.Kirby-Bauer（K-B） were used for drug sensitive test and WHONET5.4 for statistics.Results We isolated 172 strains of citrobacteT.Of which C.freundii was major（70.3%）,then Citrobacter amalonaticus（14.0%） and Citrobacter diversus（5.2%）.In 172 strains of citrobacte which came mainly from respiratoy tract（67.4%） and urogenital tract was the next（22.1%）.The infected ward were neurology ward（29.1%）,respiratoy ward（27.9%）nephrology ward（16.9%） and oncology ward（11.0%）.Drug sensitive test showed higher resistance rate in 172 strains of citrobacter to ampicillin,cefazolin and Cefoxitin were above 87%,while to amikacin,imipenem and sulperazone were lower 20%.Conclusion C.freundii was the common citrobacter in nosocomial infection and came mainly from respiratory tract.Citrobacter produced multi-β-lactamase resistance.Imipenem,sulperazone and amikacin have higher antibacterial activities to citrobacte.