我院革兰阴性菌对头孢西丁耐药的分析

目的分析本院近四年分离的2235株革兰阴性菌对头霉素类抗菌药物的敏感性。方法细菌鉴定、药敏分析、产超广谱β-内酰胺酶（ESBLs）检测均由本院检验科细菌室专业人员按操作规程进行。结果临床分离的6种革兰阴性菌2238株中876株（39．14％）细菌对头孢西丁耐药，其中嗜麦芽窄食单胞菌、铜绿假单胞菌及不动杆菌对头孢西丁的耐药程度较高，分别达到94．03％，72．56％和67．59％；奇异变形杆菌对头孢西丁全部敏感（100％）；大部分大肠埃希菌、肺炎克雷伯菌对头孢西丁仍较敏感，耐药率分别为29．73％和27．61％。结论应加强对抗菌药物合理应用的管理，特别是对β-内酰胺类抗菌药物使用的管理；细菌室应开展对AmpC酶的检测，提高细菌耐药报告的准确性，指导临床合理选用抗菌药物。

Analysis on the sensitivity of gramnegative bacterium to cefoxitin

Objective To analyse the sensitivity of isolated gramnegative bacterium to cephamycine antimicrobial in recent four years of our hospital. Methods Identification of bacteria, sensitivity analyses and ESBLs were detected by professional numbers in the Lab. of the hospital. Results Among six kinds 2238 clinical identified gramnegative strains, 876 were cefoxitin resistance（39.14% ）. Of the 2238 strains, M. Stenotrophomonas, P.aeruginnosa and A.baumanii/Calcoaceticus/ Lwoffi were more resistance to cefoxitin and were 94.03%, 72.56 % and 67.59 % respectively. All proteus mirabilis were sensitive to cefoxitin（ 100 % ）. Most escherchia coli and K. pneumoniae were still more sensitive to cefoxitin and their resistant rate were 29.73 % and 27.61% respectively. Conclusions The usage of antimicrobial must be administrated strictly, especially the using of betalactamase antimicrobial. The work of AmpC enzyme should be developed in the hospital, so as to raise the accura of reporet on bacterial resistance and make reasonable choice in antimicrobial administration clinically.