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我院耐碳青霉烯类抗菌药物革兰氏阴性杆菌的分离及其产金属β-内酰胺酶情况分析
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| 篇名： | 我院耐碳青霉烯类抗菌药物革兰氏阴性杆菌的分离及其产金属β-内酰胺酶情况分析 |
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| 摘要： | 目的：为我院临床合理应用抗菌药物提供参考。方法：对我院2013年5月－2015年12月住院患者感染革兰氏阴性杆菌的耐药及产金属β-内酰胺酶（MBLs）情况进行回顾性分析。结果：我院2013－2015年共检出革兰氏阴性杆菌2 089株，其中肠杆菌科细菌1 456株（69.70％）、非发酵菌633株（30.30％），以大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌和阴沟肠杆菌为主。共检出耐碳青霉烯类菌株406株（19.44％），包括非发酵菌367株、肠杆菌科细菌39株。耐碳青霉烯类菌株对16种抗菌药物的耐药率均大于50％，而非耐碳青霉烯类菌株的耐药率相对较低；除氨曲南外，耐碳青霉烯类菌株对其余15种抗菌药物的耐药率均显著高于非耐碳青霉烯类菌株，差异均有统计学意义（P＜0.05）。共检出产MBLs耐药菌株36株（8.87％），包括产MBLs耐药铜绿假单胞菌13株、产MBLs耐药鲍曼不动杆菌23株；未检出产MBLs耐药肠杆菌科细菌。结论：我院革兰氏阴性杆菌以肠杆菌科细菌为主；耐碳青霉烯类菌株以非发酵菌为主，耐药率普遍高于非耐耐碳青霉烯类菌株；产MBLs情况较为严重，且产酶菌株均为非发酵菌。临床应加强病原菌耐药性及产酶菌株的监测，避免不合理应用抗菌药物而造成耐药菌株的产生与传播。 |
| ABSTRACT： | OBJECTIVE： To provide reference for rational use of antibiotics in the clinic of our hospital. METHODS： Drug resistance of Gram-negative bacillus in the inpatients of our hospital were analyzed retrospectively during May 2013-Dec. 2015 as well as the situation of producing metallo-β-lactamase （MBLs）. RESTUTS： A total of 2 089 strains of Gram-negative bacillus were detected in our hospital during 2013-2015， among which there were 1 456 strains of enterobacteria （69.70％） and 633 strains of non-fermentative bacteria， mainly involving Escherichia coli， Pseudomonas aeruginosa， Klebsiella pneumoniae， Acinetobacter baumannii and Enterobacter cloacae. A total of 406 strains of carbapenems-resistant bacteria were detected （19.44％）， including 367 strains of non-fermentative bacteria and 39 strains of enterobacteria. The resistant rates of carbapenems-resistant strains to 16 antibiotics were all higher than 50％， but those of non-carbapenems-resistant strains were in relative low level. Except for aztreonam， resistant rates of carbapenems-resistant strains to other 15 antbiotics were all higher than those of non-carbapenems-resistant strains， with statistical significance （P＜0.05）. A total of 36 strains of producing MBLs were detected （8.87％）， including 13 strains of producing MBLs drug-resistant P. aeruginosa and 23 strains of producing MBLs drug-resistant A. baumannii； producing MBLs drug resistant enterobacteria had not been found. CONCLUSIONS： Gram-negative bacillus are mainly enterobacteria in our hospital； carbapenems-resistant strains are mainly non-fermentative bacteria， resistant rate of them are commonly higher than that of non-drug-resistant strain. The situation of producing MBLs is serious， and enzyme producing strains are mainly non-fermentative bacteria. It is necessary to strengthen drug resistance of pathogen and enzyme producing strain monitoring， avoid the generation and spreading of drug-resistant strains due to irrational use of antibiotics. |
| 期刊： | 2017年第28卷第11期 |
| 作者： | 郑光敏，庞菲，李玮，霍建敏，杨建军 |
| AUTHORS： | ZHENG Guangmin，PANG Fei， LI Wei，HUO Jianmin，YANG Jianjun |
| 关键字： | 革兰氏阴性杆菌；碳青酶烯类；耐药性；金属β-内酰胺酶 |
| KEYWORDS： | Gram-negative bacillus； Carbapenems； Drug resistance； Metallo-β-lactamase |
| 阅读数： | 497 次 |
| 本月下载数： | 14 次 |
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