2006～2013年某院常见肠杆菌科细菌耐药监测

盛皓宇,王文节,侯为顺

(皖南医学院附属弋矶山医院感染性疾病科，安徽芜湖241001)

【摘要】目的：了解常见临床分离肠杆菌科细菌对常用抗菌药物的耐药性及其变迁情况。为临床抗感染治疗选择用药提供参考依据。方法：收集2006～2013年我院细菌室从各类标本中分离出的菌株，对常见肠杆菌科细菌药物敏感性进行回顾性分析，用SPSS 13.0软件进行数据分析。结果：8年间共收集肠杆菌科细菌5 797株。其中大肠埃希菌2 470株，位居第一；其次为肺炎克雷伯菌，共2 294株；再次为奇异变形杆菌，共316株。敏感性最高的抗菌药物为碳青霉烯类，其次为头胞哌酮舒巴坦。8年间大肠埃希菌、肺炎克雷伯菌ESBLs检出率分别为56.75%和32.18%。大肠埃希菌对头胞哌酮舒巴坦耐药率呈下降趋势，对头孢西丁耐药率呈上升趋势；肺炎克雷伯菌耐药性变化不大，对多数抗菌药物的耐药率低于大肠埃希菌。结论：碳青霉烯类对于常见肠杆菌科细菌有极高的抗菌活性；产ESBLs大肠埃希菌菌株呈增多趋势，多重耐药菌株增多，特别是近年来耐碳青霉烯类菌株增多，需引起重视并监测其变化趋势。

【关键词】肠杆菌科；抗菌药物；耐药变迁

【文献标识码】【中图号】R 446.5A

DOI【】10.3969/j.issn.1002-0217.2015.02.017

文章编号：1002-0217(2015)02-0165-03

收稿日期：2014-08-15

作者简介：张政(1987-)，男，2012级硕士研究生，(电话)15855961959，(电子信箱)626019438@qq.com；

通讯作者丁伯应，男，主任医师，(电子信箱)dby0067@126.com，.

Surveillance over the drug resistant Enterobacteriaceae in a nosocomial settings: 2006～2013SHENGHaoyu,WANGWenjie,HOUWeishun

Department of Infectious Diseases,Yijishan Hospital,Wannan Medical College,Wuhu 241001,China

Abstract【】Objective：To investigate the commonly isolated strains of drug resistant Enterobacteriaceae in nosocomial settings and their distribution in order to supply evidence with rationale drug use in clinic.Methods:The total strains were isolated from specimens maintained in the bacterium laboratory of a hospital between 2006 and 2013.Sensitivity of the common gut Enterobacteriaceae to the currently available antibiotics was retrospectively examined through data analysis with SPSS13.0 software.Results:A total of 5 797 strains of Enterobacteriaceae were harvested in eight years,in which Escherichia coli stood top(2 470 strains) on the list,followed by Klebsiella pneumoniae(2 294 strains) and Proteus mirabilis(316 strains).The highest sensitivity of the above bacteria to antibiotics included carbapenem and Cefoperazone Shubatan.The detection rate of Escherichia coli and extended-spectrum β-lactamases (ESBLs)production of by Klebsiella pneumoniae was 56.75% and 32.18%,respectively in 8-year-period.Resistance of Escherichia coli to Cefoperazone Shubatan appeared to decline,yet tended to climb to Cefoxitin.Klebsiella pneumoniae resistance to available drugs remained little change,and had lower resistance rate for most antibiotics than Escherichia coli.Conclusion:Carbapenems has higher antibacterial activity for common Enterobacteriaceae,and ESBLs-producing Escherichia coli strains as well as multi-drug resistant strains tend to climb,especially rise of carbapenem-resistant strains in recent years,suggest that these strains require more intensive surveillance over their changes.

【Key words】 Enterobacteriaceae;antibiotic;drug resistance change

肠杆菌科细菌是尿路感染、血液感染、腹腔内感染、肺部感染的常见致病菌，是医院内感染的重要病原菌。近年来随着抗菌药物的广泛应用，其耐药菌株、多重耐药菌株不断增多，给临床治疗造成极大困难。……