2013年我院血培养主要革兰阴性杆菌分布及耐药性分析

目的了解我院血培养中的革兰阴性（G-）杆菌的分布及对常用抗生素的耐药情况，为合理使用抗菌药物提供依据。方法采用法国梅里埃的Bact／ALERT 3D 60血培养仪和美国BD公司PHOENIX100全自动细菌鉴定分析仪进行培养鉴定和药敏实验。结果分离到的G-杆菌中，主要有大肠埃希菌、肺炎克雷伯菌肺炎亚种、铜绿假单胞菌等，大肠埃希菌对哌拉西林／他唑巴坦（TZP）、亚胺培南（IPM）、阿米卡星（AN）、美洛配能（MEM）的耐药率均〈10％；肺炎克雷伯菌肺炎亚种对阿米卡星（AN）、美洛配能（MEM）、亚胺培南（IPM）的耐药率分别为10．5％、7．9％、5．3％：铜绿假单胞菌对庆大霉素（GM）、多粘菌素（CL）的耐药率分别为5．0％、0．0％。三种常见分离菌对其余抗生素耐药率都相对较高，有的甚至已经100％耐药。结论本院血培养中分离出的常见三种G-杆菌中耐药率严重，应引起临床重视，必须严格合理用药。

Analysis of the main gram negative bacteria distribution and drug resistance of blood culture in our hospital in 2013

Objective To understand the gram negative blood culture in our hospital（G-） bacteria distribution and resistance to antibiotics, provide the basis for the rational use of antimicrobial agents. Methods The French bioMerieux Bact/ALERT 3D 60 blood culture system and American BD PHOENIX 100 automatic bacteria identification instrument culture identification and drug sensitive experiment. Results Isolated strains of G- bacteria, mainly Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli sensitive antibiotic piperaciUin/ tazobactam （TZP）, imipenem （IPM）, Amikacin（AN）, meropenem（MEM）, the resistance rate of less than 10%. Amikacin was sensitive to the Klebsiella pneumoniae subspecies（AN）, meropenem（MEM）, imipenem （IPM）, resistance rates were 10.5%, 7.9%, 5.3%, gentamicin was sensitive to the Pseudomonas aernginosa （GM）, polymyxin hormone （CL）, resistance rates were 5.0%, 0.0%. Three kinds of common bacteria isolated from the rest of the antibiotic resistance rate was relatively high, and some even had 100% resistance. Conclusion The blood culture isolate three common resistant G- coli rate is serious, should cause clinical attention, must strictly rational drug use.