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1、·252·皖南醫(yī)學院學報(JofWannanMedicalCollege)2014;33(3·臨床醫(yī)學·文章編號:1002—0217(2014)03—0252—04安徽省某醫(yī)院多重耐藥革蘭陰性菌流行情況及耐藥分析朱紅,喻艷林,侯為順,楊劍,謝文斌(皖南醫(yī)學院附屬弋磯山醫(yī)院感染性疾病科,安徽蕪湖241001)【摘要】目的:了解2011—2013年我院臨床分離多重耐藥革蘭陰性菌流行情況、耐藥及變遷。方法:采用Vitek一32全自動微生物分析儀及紙片擴散法對分離菌進行鑒定及藥敏實驗。結果:3年期間臨床分離多重耐藥菌共1905株
2、,占分離病原菌的18.9%,其中革蘭陰性菌占74.6%。分離出的多重耐藥革蘭陰性菌數(shù)依次為大腸埃希菌、肺炎克雷伯菌、醋酸鈣鮑曼復合不動桿菌、銅綠假單胞菌。多重耐藥大腸埃希菌、肺炎克雷伯菌對碳青霉烯類3年內(nèi)均保持極低的耐藥率,對頭孢哌酮/舒巴坦雖保持高的敏感性,但耐藥率呈增高趨勢。多重耐藥銅綠假單胞菌、鮑曼復合不動桿菌耐藥率高,對常用抗生素耐藥率多在50%以上,部分為泛耐藥株。結論:多重耐藥菌對常用抗菌藥物耐藥狀況嚴重,需加強抗感染管理制度執(zhí)行和多重耐藥菌的監(jiān)測,并根據(jù)藥敏試驗結果合理應用抗菌藥物。【關鍵詞】細菌藥敏試驗;
3、多重耐藥菌;多重耐藥革蘭陰性細菌;耐藥性;合理用藥【中圖號】R446.5【文獻標識碼】A【DOI】10.3969/j.issn.1002-0217.2014.03.021Epidemiologicalcharacteristicsofmultidrug·-resistantgram--negativebacteriainahospitalinAnhuiprovinceanddrugresistanceanalysisZHUHong,YUYanlin,HOUWe~hun,YANGJian,XIEWenbinDepartme
4、ntofInfectiousDiseases,YijishanHospital,WannanMedicalCollege,Wuhu241001,China【Abstract】Objective:Tounde~tandepidemiologicalcharacteristics,drugresistanceandchangingtendencyofmuhidrug-resistantgram—negativebacteriaisolatedinourhospitalduringtheperiodof2011—2013.Me
5、thods:Vitek-32automaticmicrobialanalyzerwasusedtoidentifythebacteriaisolatedanddiscdiffusionmethodforexaminingthedrugsusceptibility.Results:Ina3一yearperiod,atotalof1905muhidrug—resistantbacteriastrainswereidentified,whichaccountedfor18.9%ofthepathogenicbacteria.a(chǎn)
6、nd74.6%weregram—negativebacteria.Theisolatedmuhidrug—resistantgram-negativebacteriaweresequentiallywithEscherichiacoli,Klebsiellapneumoniae,CalciumacetatecompositeacinetobacterbaumannandPseudomonasaeruginosa.EscherichiacoliandKlebsiellapneumoniaofmuhidrug—resista
7、nceremainedlowerdrugresistancerateforCarbapenemsin3years.AhhoughthebacteriamaintainedhighsensibilitytoCefoperazone-sulbactam,thedrugresistanceratetendedtoincrease.Higherresistancerateswerefoundformuhidrug—resistantPseudo—monasaeruginosaandAcinetobacterbaumannii.i
8、nwhichover50%wereresistanttoconventionalindividualantibiotics,andworseenough,someofthestrainswerepan-drugresistance.Conclusion:Resistancetoconventionalindividu