2005-2009年医院感染革兰阴性杆菌的分布及耐药性分析

目的 了解医院常见革兰阴性杆菌的种类及耐药性,为临床抗感染治疗提供依据.方法 回顾性分析2005年1月-2009年12月临床分离的8501株革兰阴性杆菌；采用纸片扩散法进行药物敏感试验,结果判定参照CLSI标准.结果 临床分离的革兰阴性杆菌呈逐年上升趋势,5年共检测到8501株,其中大肠埃希菌占51.3％、克雷伯菌属占18.9％、铜绿假单胞菌占10.7％、不动杆菌属占6.3％,并呈多药耐药性；大肠埃希菌中产ESBLs菌株约为64.1％,克雷伯菌属为79.6％.结论 医院革兰阴性杆菌的耐药性已非常严重,加强细菌耐药性的监测与控制,根据药敏试验结果合理使用抗菌药物,对控制感染是非常重要的.

Distribution and drug resistance of Gram-negative bacilli causing nosocomial infections from 2005 to 2009

OBJECTIVE To study the category and drug resistance of Gram-negative bacilli and provide the scientific evidence for the clinical treatment of infectious diseases.METHODS There were 8357 strains of Gram-negative bacillus obtained from clinical patients in the second affiliated hospital of Kunming medical college from January 2005 December 2009.K-B test was used to determine drug susceptibility and the results were read based on 2009 Clinical and Laboratory Standards Institute(CLSI).RESULTS The number of gram-negative bacillus isolated in clinical cases was increasing year by year,of which 8501 strains were detected in 5 years,Escherichia coli accounted for 52.1%,Klebsiella accounted for 15.2%,Pseudomonas aeruginosa accounted for 10.8% and Acinetobacter accounted for 8.0%.Most bacteria showed multi-drug resistance.The isolating rates of ESBLs among ECO and KPN were 63.6% and 57.6%,respectively.CONCLUSION The drug resistance rate of gram-negative bacillus in the second affiliated hospital of Kunming medical college’ has become a serious problem,so strengthening monitoring and control of drug resistance and reasonable use of antimicrobial drugs according to results of drug susceptibility test are extremely important for infection control.