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目的了解昆明医科大学第一附属医院耐碳青霉烯类弗氏柠檬酸杆菌的分布及药敏情况,指导临床合理用药.方法收集2012年1月至2014年12月临床送检标本中分离到的弗氏柠檬酸杆菌,通过VITEK-2系统测定抗菌药物的最低抑菌浓度(MIC),分析碳青霉烯类耐药的弗氏柠檬酸杆菌的耐药特点.结果 (1)分离的21株耐碳青霉烯类弗氏柠檬酸杆菌中,主要标本来源为尿液(95%),科室分布以移植中心(66.7%)和泌尿外(19%)为主;(2)药敏结果显示待测菌株对头孢菌素类及其酶抑制剂均高度耐药,甚至对碳青霉烯类抗生素也高度耐药,其中亚胺培南耐药率为90%(95%CI:70~99),美罗培南耐药率为85.7%(95%CI:64~97),以阿米卡星耐药率最低(4.8%),其次为呋喃妥因(10.5%)和磷霉素(15%).结论昆明医科大学第一附属医院耐碳青霉烯类的弗氏柠檬酸杆菌引起的感染以泌尿道感染多见,且多重耐药为其显著特点,应加强耐药监测,指导临床规范用药,控制耐药株的流行.
Objective To understand the distribution and drug susceptibility of C. citricola resistant to carbapenem in the First Affiliated Hospital of Kunming Medical University and to guide clinical rational use of drugs.Methods The clinical isolates collected from January 2012 to December 2014 were isolated Of Citrobacter freundii, the antibacterial activity of carbapenem-resistant Citrobacter freundii was analyzed by VITEK-2 system.Results (1) Isolation of 21 Among the strains resistant to carbapenem-resistant citrobacter freundii, the main source of specimen was urine (95%), and the distribution of the departments was mainly in the center of graft (66.7%) and urinary (19%). (2) The results showed that the tested strains were highly resistant to cephalosporins and their enzyme inhibitors and even highly resistant to carbapenem antibiotics. The resistant rate of imipenem was 90% (95% CI: 70 ~ (95% CI: 64-97). The resistance rate of meropenem was the lowest (4.8%), followed by nitrofurantoin (10.5%) and fosfomycin (15%) .Conclusion The first Affiliated Hospital of Kunming Medical University carbapenem-resistant Citrobacter freundii infection caused by urinary tract infections more common, and multi-drug resistance is its salient features, should be strengthened resistance Testing, clinical standard medication, to control the prevalence of resistant strains.