医院感染革兰阴性菌的分布及对抗菌药物的耐药性研究

目的：研究医院感染革兰阴性菌的分布及对抗菌药物的耐药性。方法回顾性分析该院2015年1一12月各科室送检标本中分离出的2361株革兰阴性菌,包含大肠埃希菌(ECO）、铜绿假单胞菌(PAE）、肺炎克雷伯菌(KPN）和鲍氏不动杆菌(ABA）非重复菌株,采用相关仪器进行细菌鉴定和药敏试验。结果2361株革兰阴性菌中,ECO 1290株,占54.64%(1290/2361）,PAE 348株,占14.74%(348/2361）,KPN 536株,占22.70%(536/2361）,ABA 187株,占7.92%(187/2361）;PAE、KPN、ABA的分布主要在痰液中,ECO的分布主要在中段尿中;ECO中检出产ESBLs-ECO (超广谱β-内酰胺酶）536株,占41.55%(536/1290）,KPN中检出产ESBLs-KPN 213株,占39.74%(213/536）,产ESBLs菌株的耐药率高于非产ESBLs;PAE对阿米卡星的耐药率最低(4.31%）,ABA对头孢哌酮/舒巴坦的耐药率最低(31.55%）。结论革兰阴性菌广泛存在于医院感染中,且具有较强的耐药性,临床上应做好细菌耐药性检测,选择稳定高敏的抗菌药物治疗感染。

Study of Distribution of Gram Negative Bacteria in Hospital Infection and Drug Resistance to Antibiotics

Objective To study the distribution of gram negative bacteria in hospital infection and the drug resistance to antibiotics. Methods A retrospective analysis of our hospital January 2015 to December 2015 departments each submission were isolated from the 2361 Gram-negative bacteria, including Escherichia coli (ECO), Pseudomonas aeruginosa (PAE), K. pneumoniae (KPN) and Martin Acinetobacter (ABA) non-repetitive strains, using the relevant instruments bacterial identifi-cation and susceptibility testing. Results 2361 Gram-negative bacteria, ECO 1290 strains, accounting for 54.64% (1290/2361), PAE 348 strains accounted for 14.74% (348/2361), KPN 536 strains, 22.70%(536/2361), ABA 187 strains, account-ing for 7.92% (187/2361);PAE, KPN, ABA distributed mainly in the sputum; ECO distributed primarily in the urine; ECO in the production of ESBLs-ECO (extended spectrum beta -) 536 strains, accounting for 41.55% (536/1290), KPN in the production of ESBLs-KPN 213 strains, accounting for 39.74% (213/536), the resistance rate of ESBLs producing strains was higher than non production ESBLs; PAE resistance to Amikacin was the lowest (4.31%), ABA of Cefoperazone / sulbactam was the lowest (31.55%). Conclusion Gram negative bacteria are widely existed in hospital infection, and have strong drug resistance. Bacterial drug resistance testing should be done in the clinic, and the selection of stable highly sensitive antimi-crobial agents for the treatment of infection.