齐鲁医院1232株革兰阴性杆菌的分布及其耐药监测

目的：了解院内感染革兰阴性杆菌的分布及其耐药情况。方法：收集病房各类感染标本中分离出的1232株革兰阴性杆菌，采用传统的纸片扩散法(K-B法)检测其耐药性。结果：最常见的革兰阴性杆菌为铜绿假单胞菌(23．9％)、大肠埃希菌(19．5％)、不动杆菌(18．4％)、肺炎克雷伯杆菌(10．6％)等。大肠埃希菌、肺炎克雷伯杆菌及粘质沙雷氏菌超广谱β-内酰胺酶的发生率分别为20．0％、33．3％和25．0％；阴沟肠杆菌AmpC的发生率为24．0％。嗜麦芽窄食单胞菌、洋葱伯克霍尔德菌、脑膜炎败血黄杆菌对所监测的抗生素广谱耐药。亚胺培南、头孢他定对铜绿假单胞菌的耐药性增加到29．4％、19．1％(R I)。三代头孢及氨曲南对产诱导酶细菌呈交叉耐药。结论：革兰阴性杆菌有较严重的耐药性，应加强耐药监测，合理使用抗生素。

Antibiotics resistance of 1 232 strains of gram-negative bacillus in Qilu Hospital

Objective:To investigate the outbreak and drug resistance of gram-negative bacil- lus in hospital.Methods:Drug resistance of 1 232 strains of gram-negative bacillus was tested by disk diffusion method.Results:Among 1 232 strains of gram-negative bacillus in Qilu Hospital from January of 2001 to May of 2002,the main bacillus were Pseudomonas aeruginosa(23.9%),Escherichia coli (19.5%),Acinetobacter(18.4%)and Klebsiella pneumoniae(10.6%).Among 221 strains of E.coli,120 strains of K.pneumonie and 71 strains of Serratia marcescens,the detectable rates of producing ESBLs bacteria were 20.0%,33.3% and 25.0% respectively.The detectable rate of producing AmpC bacteria from 79 strains of Enterobacter cloacae was 24.0%.Stenotrophomonas maltophilia,Burkholderia cepacia and Flavobacterium meningosepticum were multi-drug resistant to 11 tested drugs.The resistant rates of P.aeruginosa to Imipenem and Cefetadim were increased to 29.4% and 19.1% respectively.Conclusion: Most of gram-negative bacillus in hospital were seriously resistant,so it is very important to select an- tibiotics to treat infections according to the results of susceptibility tests.