2012年河北省临床分离阴沟肠杆菌耐药监测分析

目的 调查2012年河北省临床分离的阴沟肠杆菌对常用抗菌药物的耐药现状,为区域内临床合理用药提供支持.方法 按细菌耐药监测方案要求,收集17家河北省细菌耐药监测网成员单位临床分离的阴沟肠杆菌数据,用CLSI2010标准,用Whonet5.6分析数据.结果 共收集阴沟肠杆菌398株,占革兰阴性杆菌分离量的第5位,大多数为呼吸道标本.阴沟肠杆菌对第一、二代头孢菌素的耐药率高（＞50％）,对头孢吡肟（29.0％）、头孢噻肟（20.1％）的耐药率低.哌拉西林/他唑巴坦（8.1％）、头孢哌酮/舒巴坦（9.0％）、碳青霉烯类药物（＜9％）的耐药率最低,可作为临床重症感染首选药.氨基糖苷类和喹诺酮类药物也有较好的抗菌活性.结论 阴沟肠杆菌对抗菌药物呈现不同程度的耐药,碳青霉烯类抗菌药物是抗菌活性最高的药物,但应警惕阴沟肠杆菌耐药菌株的出现,控制耐药菌的发生与传播.

Antimicrobial Resistance Investigation of Enterobacter Cloacae in Hebei in 2012

Objective To investigate the antimicrobial resistance of Enterobacter Cloacae clinically isolated in Hebei province in 2012.Methods The bacterial data was collected from 17 hospitals which were member units of Hebei Antimicrobial Resistance Investigation Net（hebarin） according to surveillance program in Hebei province.WHONET 5.6 was used to review,analyze and summarize the collected surveillance data referring to CLSI guideline 2010.Results Totally 389 EnterobacterCloacae were isolated in this study.Among all the isolate,Enterobacter Cloacae ranked the fifth place which were mainly respiratory specimens.The drug susceptibility test results showed that the drug resistant rates of Enterobacter Cloacae to first and second generation cephalosporin were more than 50％.The rates of drug resistance to Cefepime and Cefotaxime were low,respectively 29.0 ％ and 20.1 ％.Piperacillin/tazobactam （8.1 ％）,cefoperazone/sulbactam （9.0 ％） and Carbapenems （＜9 ％） were the most potent antimicrobial agents against Enterobacter cloacae and could be used as the first choice in clinical severe infection.Aminoglycosides and quinolones also showed good antibacterial activity.Conclusion Enterobacter cloacae showed varying degrees of antimicrobial resistance.Carbapenem antibacterial drugs were still the most active drugs.However,the emergence of resistant strains of Enterobacter cloacae should be paid more attention and measures should be taken to control resistant development and dissemination of drug bacteria resistant.