5 538株肠杆菌科细菌感染分布及其耐药性

目的了解某院临床分离的肠杆菌科细菌感染分布及对常用抗菌药物的耐药性。方法对该院2005年1月-2012年6月临床分离的肠杆菌科细菌的资料进行统计分析。结果共分离肠杆菌科细菌5 538株,标本来源前3位依次为：尿液（35.63%，1 973株），呼吸道（32.38%，1 793株），伤口分泌物、引流液及脓液（10.88%，603株）；居前5位的病原菌分别为大肠埃希菌（49.41%，2 736株）、肺炎克雷伯菌（25.30%，1 401株）、阴沟肠杆菌（6.37%，353株）、奇异变形杆菌（4.24%，235株）和沙门菌属（4.17%，231株）。绝大多数肠杆菌科细菌对亚胺培南和美罗培南的耐药率＜2％；阿米卡星和哌拉西林/他唑巴坦对肠杆菌科细菌仍保持较好的抗菌活性，耐药率＜10%。痰标本分离的大肠埃希菌耐药率明显高于血和尿标本分离的大肠埃希菌（均P＜0.05）。结论该院肠杆菌科细菌主要分离自尿和呼吸道标本；对各类抗菌药物呈现不同程度耐药，碳青霉烯类药物仍是肠杆菌科细菌最敏感的抗菌药物，但已出现碳青霉烯耐药株，应引起重视。

Distribution and antimicrobial resistance of infection caused by 5 538 Enterobacteriaceae isolates

Objective To investigate the distribution and antimicrobial resistance of infection caused by clinically isolated Enterobacteriaceae from a hospital.Methods Data about Enterobacteriaceae isolated from January 2005 to June 2012 was analyzed statistically.Results A total of 5 538isolates of Enterobacteriaceae were isolated,the top three specimen sources were urine（35.63%,1 973isolates）,respiratory tract（32.38%,1 793isolates）,wound secretion,drainage and pus（10.88%,603isolates）;the top five isolated pathogens were Escherichia coli（49.41%,2 736isolates）,Klebsiella pneumoniae（25.30%,1 401 isolates）,Enterobacter cloacae（6.37%,353 isolates）,Proteus mirabilis（4.24%,235 isolates）and Salmonella spp.（4.17%,231isolates）.The resistant rates of most Enterobacteriaceae to imipenem and meropenem were2%;amikacin and piperacillin/tazobactam were with high activity against Enterobacteriaceae,the resistant rate was10%.Resistance rate of Escherichia coli from sputum specimens was significantly higher than those from blood and urine specimens（both P0.05）.Conclusion Enterobacteriaceae in this hospital are mainly isolated from urine and respiratory tract,and with varied degree of resistance to different antimicrobial agents,carbapenems remains high activity against Enterobacteriaceae,attention should be paid to the emergence of carbapenem-resistanct strains.