摘要
目的了解本院2006-2008年住院患者痰液中病原菌的主要种类和耐药性,为合理使用抗菌药物提供依据。方法大多数分离细菌的鉴定和药敏试验利用BD Phoenix仪,少数利用手工鉴定和K-B法进行药敏试验。念珠菌利用显色平板分离和鉴定,采用K-B法进行药敏试验。数据分析用WHONET5.4软件。结果住院患者痰液中细菌以铜绿假单胞菌、鲍曼不动杆菌、金黄色葡萄球菌和肺炎克雷伯菌为主,念珠菌属以白色念珠菌为主。痰液中G-杆菌耐药率一直较低的为亚胺培南、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦。大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)的检出率为56.0%～69.0%和59.7%～68.1%。痰液中G+球菌对万古霉素和替考拉宁的敏感率一直为100%,其他抗菌药物的耐药率均较高。金黄色葡萄球菌和凝固酶阴性葡萄球菌甲氧西林耐药率居高不下,为68.0%～71.6%和85.8%～90.0%。念珠菌属对两性霉素B和制菌霉素的耐药率均为0。结论住院患者痰液中大肠埃希菌和肺炎克雷伯菌产ESBLs水平、非发酵G-杆菌碳青霉烯类耐药率和葡萄球菌属甲氧西林耐药率均不断增高或居高不下,应加强抗菌药物的合理使用,以降低耐药率;采取有效的隔离措施可以防止多重耐药菌的扩散。
Objective To investigate distribution and drug resistance of clinical bacteria and candida isolates from sputums of hospital patients. Methods Most of the bacteria isolates were identified by BD Phoenix, a few were identified with handy-method and K-B method. Candida isolates were identified with color display plate and K-B method. WHONETS.4 was applied for analysis. Results The common bacteria isolates were P.aeruginosa,A. baumannii, S.aureu, K.pneumonioe. The common candida isolate was C.albicans. In gram negative bacillus from sputum, resistant rates of Imipenem, Cefoperazone/Sulbactam, Piperacillin/Tazobactam were low. The incidences of E.coli and K. pneumoniae isolates producing extended spectrum beta-lactamase （ESBLs） were 56.0%-69.0% and 59.7%-68.1% respectively. In gram positive coccus from sputum,sensitive rates of Vancomycin and Teicoplanin were both 100%, resistant rates of other antibiotics were high.The methicillin resistant rates of S.aureu and coagulase negative staphylococcus were 68.0%-71.6% and 85.8%-90.0%, respectively. In Candida isolates, resistant rates of Amphotericin B and Nystain were both 0.0%. Conclusion The production ratios of ESBLs of E.coli and K. pneumoniae ,carbopenems resistant rates of non-ferment gram negative bacillus, and methicillin resistant rates of staphylococci were increasing or high all time. It is important to enforce the rational use of antimicrobial agents to reduce resistant rates of bacteria and take effective quarantine measures to reduce dissemination of multi-resistant bacteria.
出处
《热带医学杂志》
CAS
2009年第12期1400-1404,共5页
Journal of Tropical Medicine
关键词
细菌
耐药
超广谱Β-内酰胺酶
甲氧西林耐药性
bacteria
drug resistance
extended spectrum beta-lactamases
methicillin resistance
