2005-2007年北京市5家三级甲等医院急诊科感染患者革兰阴性杆菌药敏变迁情况分析

目的 调查北京市大型医院急诊科感染患者革兰阴性杆菌药敏状况及抗生素耐药变迁规律.方法 对北京市5家三级甲等医院2005-2007年急诊科感染患者细菌培养结果进行回顾性分析,了解革兰阴性杆菌的分布状况及抗生素耐药变迁规律.结果 共分离革兰阴性杆菌2 285株,占64.62%,居前5位的为铜绿假单胞菌(占23.89%)、大肠埃希菌(占19.91%)、鲍曼不动杆菌(占17.59%)、肺炎克雷伯菌(占8.05%)、嗜麦芽窄食单胞菌(占3.94%).2005-2007年,细菌的抗生素敏感率出现了明显的下降趋势,尤以常用抗生素如头孢菌素类、碳青霉烯类和喹诺酮类下降显著,其中铜绿假单胞菌对亚胺培南的耐药率2005、2006、2007年分别为17.30%、22.53%、31.92%,鲍曼不动杆菌对亚胺培南的耐药率分别为13.87%、12.09%、23.56%.结论 大型综合医院急诊科细菌谱趋向于医院感染的特点,细菌的抗生素敏感率出现明显下降的趋势,抗生素耐药形势不容乐观.

Vicissitude of antibiotic sensitivity of Gram negative bacilli in patients with infection in emergency departments in Beijing during 2005 to 2007

Objective To investigate changes in antibiotic sensitivity of Gram negative bacilli infections among emergency patients in large hospitals in Beijing during 2005 to 2007. Methods Retrospective analysis of all the identified strains of Gram negative bacilli, and their sensitivity to antibiotic obtained in the emergency departments of 5 top first-class hospitals in Beijing for recent 3 years. Results Two thousand two hundred and eighty-five strains of Gram negative bacilli had taken 64.62% of all, the priority 5 of which were Pseudomonas aeruginosa (23.89%), Escherichia coli (19.91%), Acinetobacter baumanii (17.59%), Klebsiella pneumoniae (8.05%) and Staphylococcus maltophilia (3.94%). The sensitivity of commonly used antibiotics plummeted greatly in recent 3 years, especially carbapenems, cephalosporins and quinolones. The resistance of imipenem-resistant Pseudomonas aeruginosa was 17.30%, 22.53%, 31.92% respectively. The resistance of imipenem-resistant Acinetobacter baumanii was 13.87%, 12.09%, 23.56% respectively. Conclusion Infectious bacteria in emergency departments in Beijing top first-class hospitals tend to show the characteristics of hospital infection. In recent years, the sensitivity of bacilli to antibiotic has dropped greatly. The situation of antibiotics resistance might be depressed.