革兰阴性菌_；_超广谱β_内酰胺酶；_耐药性；

我院2000年～2003年革兰阴性菌分离及耐药性分析

http://www.100md.com 《中国抗生素杂志》 2006年第1期

革兰阴性菌,；,超广谱β,内酰胺酶；,耐药性；,抗菌药物,,革兰阴性菌,；,超广谱β,内酰胺酶；,耐药性；,抗菌药物,1材料与方法,2结果,3讨论,参考文献

     摘要：目的了解我院2000年～2003年革兰阴性菌分离及耐药性状况。方法细菌鉴定用手工法和VITEK全自动微生物鉴定仪，药物敏感性试验采用纸片琼脂扩散法。结果 2000年～2003年共分离细菌4812株，革兰阴性菌3491株(725%)，铜绿假单胞菌、大肠埃希菌、克雷伯菌属、不动杆菌属和阴沟肠杆菌为主要分离菌。大肠埃希菌对亚胺培南、头孢吡肟、阿米卡星、头孢他啶、头孢哌酮/舒巴坦、氨曲南、头孢噻肟和阿莫西林/克拉维酸的耐药率在30%以下，对环丙沙星的耐药率高于50%(501%～706%)。克雷伯菌属对亚胺培南、头孢吡肟和头孢他啶的耐药率低于30%，对环丙沙星的耐药率在56%～333%；产ESBLs大肠埃希菌检出率为171%～206%；产ESBLs克雷伯菌属检出率为188%～276%。铜绿假单胞菌对亚胺培南的耐药率为211%～416%，不动杆菌对亚胺培南的耐药率为0～115%。结论四年间分离的致病菌以革兰阴性菌为主，且非发酵菌分离率已超过肠杆菌科细菌，耐药菌株的分离率及细菌对抗生素的耐药性逐年增加。临床医师应当合理使用抗生素以降低细菌的耐药性并采取有效的措施以控制耐药菌株的播散。

    关键词：革兰阴性菌；超广谱β 内酰胺酶；耐药性；抗菌药物

    An analysis of drug resistance and isolation of Gramnegative bacilli

    in the Naval General Hospital of PLA from 2000 to 2003

    Han Shanqiao, Liu Jinhong, Wang Dapeng, Jiang Tao,

    Huo yan, Xu Huabiao, Shao Pei and Yu Jiyao

    (Naval General Hospital of PLA, Beijing 100037)

    ABSTRACT Objective To investigate the isolation and drug resistance of Gramnegative bacilli in the Naval General Hospital of PLA from 2000 to 2003. Methods The bacteria identification were done manually and by VITEK Auto Microbe System. Microbial sensitivity tests were performed with the KirbyBauer method. Results Among the 4812 clinical isolates during 2000～2003, 3491 strains were Gramnegative bacilli (725%). The most prevalent isolates were Pseudomonas aeruginosa, Escherichia coli, Klebsiella spp., Acinetobacter spp. and Enterobacter cloacae. The resistance rates of Escherichia coli to imipenem, cefepime, amikacin, ceftazidime, cefoperazone/sulbactam, aztreonam, cefotaxime and amoxicillin/clavulanic acid were below 30%. More than 50% (501%～706%) of Escherichia coli isolates were resistant to ciprofloxacin. The resistance rates of Klebsiella spp. to imipenem, cefepime and ceftazidime were below 30%, and 56%～ 333% to ciprofloxacin. The incidences of extended spectrum βlactamaseproducing strains in Escherichia coli were 171%～206%, and those of Klebsiella spp. were 188%～276%. The resistance rates of Pseudomonas aeruginosa and Acinetobacter spp. to imipenem were 211%～416% and 0～115%, respectively. Conclusion During this fouryear period, the Gramnegative bacilli were the major bacteria isolates. The isolation rate of nonfermentative Gramnegative bacilli was higher than Enterobacteriaceae. The drug resistant bacteria and the rate of drug resistance were increasing year by year. It is very important to promote the rational use of antibiotics to minimize drug resistance and take effective measures to control the spread of drug resistant bacteria. ......

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