摘要
目的分析医院临床分离革兰阴性(G^-)杆菌的分布及药物敏感性,指导临床使用抗生素。方法回顾性分析医院2005年7月至2006年11月临床分离G^-杆菌资料。结果在分离出848株细菌中,检出G^-杆菌共566株,阳性率为66.7%,G^-杆菌前4种细菌依次是铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌和醋酸钙-鲍曼复合不动杆菌。15种抗生素的敏感率显示:亚胺培南的敏感率最高(大于87.7%),头孢曲松与头孢他啶分别为53.0%和78.8%以下。氨苄西林、氮苄西林/舒巴坦、头孢唑啉和复方新诺明对G^-杆菌前4种细菌敏感率为43.2%以下,头孢曲松、呋喃妥因对铜绿假单胞菌敏感率小于4.0%,亚胺培南是治疗铜绿假单胞菌的特效抗生素,敏感率为87.7%,其耐药性有升高趋势。结论铜绿假单胞菌是G^-杆菌引起医院感染的首位病原菌,醋酸钙-鲍曼复合不动杆菌引起的感染稳步上升。近年来,细菌多重耐药性且耐药率有上升趋势,对第3代头孢菌素和亚胺培南的耐药性明显增强。临床应选用细菌培养敏感的抗生素,以减少细菌耐药性的产生,提高治疗效果。
Objective To investigate the distribution and drug sensitivity among gram-negative bacilli isolated from clinical specimens, and to provide guidance for clinical therapy. Methods The distribution and drug sensitivity of gram-negative bacilli isolated from clinical specimens were retrospectively analyzed. The strains were isolated from our hospital from July 2005 to Nov. 2006. Results 848 strains of bacteria were isolated, out of which gram-negative bacilli （566 strains） accounted for 66.7%. The most predominant sensitive gram-negative bacillus in order was Pseudomonas aeruginosa, Escherichia coli, Klebsiellla pneumoniae and Acinietobacter calcoaceticus baumannii. Drug sensitivity test showed that sensitivity rate of imipenem was highest（〉87.7% ）, of ceftriaxone and ceftazime was below 53.0% and 78. 8% respectively. The sensitivity rates of ampicillin, ampicillin/sulbactam, cefazolin and trimethoprim-sulfamethoxazole were below 43.2 % to the four most sensitive gram-negative bacilli. The sensitivity rates of ceftriaxone and furadantin were below 4% to Pseudomonas aeruginosa. Imipenem is the first sensitive to Pseudomonas aeruginosa, and its sensitivity rate was 87.7 %. Its drug-resistance was likely to increase in recent years. Conclusion Pseudomonas aeruginosa the first main pathogenic bacterium during nosocomial infections. The infection rate of Acinietobacter calcoaceticus has been increasing steadily. In recent years, bacteria drug resistance displays characteristic of multi-resistance, and the resistance rate tends to be increasing. The resistance to the third generation cephalosporin and imipenem increases significantly. Rational use of antibiotics should be carried out according to drug sensitivity test results, and measures should be taken to reduce drug resistance.
出处
《检验医学与临床》
CAS
2007年第5期362-364,共3页
Laboratory Medicine and Clinic
