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目的调查佳木斯大学附属第一医院耐碳青霉烯类革兰阴性杆菌临床分布特点,及对常用抗菌药物的敏感性和耐药性。方法分析2015年1月-2017年1月医院临床分离的耐碳青霉烯类革兰阴性杆菌分布特点和药敏结果。药敏试验采用自动化仪器法或K-B纸片扩散法。结果 310株耐碳青霉烯类革兰阴性杆菌中,居首位的是鲍曼不动杆菌,占67.4%。药敏试验结果显示分离菌株耐药率高,仅对多黏菌素B的敏感率均>90%,全部鲍曼不动杆菌和肺炎克雷伯菌以及87%铜绿假单胞菌为多药耐药菌株,鲍曼不动杆菌耐药性最强,对环丙沙星、头孢菌素类、加酶抑制剂青霉素类和头孢替坦的耐药率>90%,对多黏菌素以外的药物敏感率<20%。结论本地区耐碳青酶烯类革兰阴性杆菌临床分布比较集中,对常用抗菌药物呈高度耐药,提示临床应加强细菌耐药性监测,合理有效使用抗菌药物。
Objective To investigate the clinical distribution of carbapenem-resistant Gram-negative bacilli in the First Affiliated Hospital of Jiamusi University and the sensitivity and drug resistance to common antibacterials. Methods The clinical characteristics and susceptibility of carbapenem-resistant Gram-negative bacilli isolated from hospital from January 2015 to January 2017 were analyzed. Drug sensitivity test using automated instrumentation or K-B disc diffusion method. Results Among the 310 strains of carbapenem-resistant Gram-negative bacilli, Acinetobacter baumannii was the highest, accounting for 67.4%. The result of drug sensitivity test showed that the isolates were highly resistant, the susceptibility rates to polymyxin B were both> 90%, all Acinetobacter baumannii and Klebsiella pneumoniae and 87% Pseudomonas aeruginosa were multi-drug Resistant strains, Acinetobacter baumannii most resistant to ciprofloxacin, cephalosporins, plus enzyme inhibitors penicillin and cefotetan resistance rate of> 90%, except for polymyxin The drug susceptibility was <20%. Conclusion The clinical isolates of Gram-negative bacilli resistant to carbapenem are concentrated in this area. They are highly resistant to commonly used antimicrobial agents, suggesting that clinical monitoring of bacterial resistance should be strengthened and antibiotics should be used reasonably and effectively.