Monitoring of drug-resistance of clinical isolates of GNB in county hospital from 2010 to 2011
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摘要: 目的:了解县级医院2010—2011年临床分离的革兰阴性杆菌对常用抗菌药物的耐药性,为临床医师合理用药提供参考依据。方法:细菌培养严格按照卫生部《全国临床检验操作规程》进行,采用法国生物梅里埃公司API系统进行细菌鉴定。药物敏感试验采用CLSL推荐的纸片扩散法(KB法)进行操作与评价。结果:2010—2011年我院临床共分离出732株革兰阴性杆菌,其中产ESBLs大肠埃希菌和克雷伯菌属检出率分别为65.6%和37.9%。所有革兰阴性杆菌对亚胺培南耐药率均<7%;肠杆菌属对哌拉西林/他唑巴坦和阿米卡星耐药率也较低,为22.1%;志贺菌属、枸橼酸杆菌属和沙雷菌属对环丙沙星耐药率<25%;变形杆菌属对大多数抗菌药物耐药率<20%;铜绿假单胞菌对头孢他啶和环丙沙星耐药率为14%,而革兰阴性杆菌对其他大多数抗菌药物耐药率表现较高。结论:我院革兰阴性杆菌对常用抗菌药物的耐药性已较为严重,应加强对抗菌药物使用的管理力度,遏制细菌耐药性快速增长的不良趋势。Abstract: Objective:To understand drug-resistance of clinical isolates of gram-negative bacilli(GNB)in county hospital from 2010 to 2011 and provide the referrence for clinical reasonable use of antibiotics.Method:Pathogenic bacteria were cultured according to the National Guide to Clinical Laboratory Procedures. API system(bioMérieux,France)was used to identify the strain. Drug susceptibility testing was performed by K-B methods recommended by CLSI. And results were assessed. Result:732 GNB were collected in our Hospital from 2010 to 2011.The detection rates of ESBLs producing E.coli and Klebsiella were 65.6% and 37.9%,respectively. Resistance of imipenem against GNB was the lower and all less than 7%.Resistance rates of piperacillin/tazobactam and amikacin against Enterobacter were also lower,being 22.1%.Resistance rates of ciprofloxacin against Shigella,Citrobacter and Serratia were less than 25%.Resistance rates of most antibiotics against Proteus were below 20%. Resistance rates of ceftazidime and ciprofloxacin against Pseudomonas aeruginosa were 14%,while gram-negative bacilli performed higher resistance to most other antibiotics. Conclusion:Resistance of commonly used antibiotics against GNB was severe in our hospital. We should strengthen management of antibiotics use to restrain the increasing tendency of bacterial resistance.
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Key words:
- county hospital /
- gram-negative bacilli /
- drug-resistance
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