粤西地区阴沟肠杆菌临床科室分布及其耐药监测

目的分析粤西地区阴沟肠杆菌（ECL）感染的临床分布及耐药状况，以指导临床合理应用抗菌药物。方法收集、分离及鉴定阴沟肠杆菌，利用纸片扩散法测定其对20种抗生素的敏感性，利用琼脂稀释法测定其对五类抗生素的最小抑菌浓度（minimal inhibitory concentration，MIC）。结果83株阴沟肠杆菌主要分离自痰液、尿液，分别占48．2％、20．5％，其余分别来源于血液、脓液、分泌物等；菌株分布于多个病区；药敏结果显示，均出现较高的耐药水平，其中对氨苄西林的耐药率最高，为96．4％，对其它抗生素的耐药率也较高，在60-3％～90．4％之间，但对亚胺培南100％敏感。结论阴沟肠杆菌主要引起呼吸道、泌尿道感染，呈现多重耐药现象，亚胺培南仍为治疗阴沟肠杆菌严重感染的首选药物。

Clinical distribution and resistance surveillance of western region Enterobacter cloacae

Objective To analyze clinical distribution and drug resistance of western Guangdong Enterobacter cloacae infections. Methods Enterobacter cloacae were collected, separated and identified, Disk diffusion method was performed to detect susceptibility of 20 antibiotics, The agar dilution method was used to detect minimum inhibitory concentration （MIC） against the five types of antibiotics. Results Of 83 Enterobacter cloacae, more were isolated from sputum, urine, accounting for 48.2%, 20.5%, respectively, the rest were from blood, drainage fluid, catheter tip, secretions, etc. The strains were distributed in various wards. Drug susceptibility results indicate that they were highly level resistance. Resistant rate to ampicillin was the highest, which was 96.4%, Resistant rates to the rest antibiotics were higher, ranging from 60.3% to 90.4%, but sensitive rate to imipenem was 100%. Conclusions Enterobacter cloacae mainly cause respiratory, urinary tract infection, showing multiple drug resistance, imipenem is still firstly drugs for the treatment of severe infections of Enterobacter cloacae.