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目的分析医院粘质沙雷菌的临床分布及耐药性,指导临床经验治疗。方法收集医院2012年1月-2014年12月的108株粘质沙雷菌,采用K-B纸片法进行药敏试验,统计分析临床分布及耐药性。结果 108株粘质沙雷菌在ICU最为常见,占27.8%,其次为神经外科和神经内科,分别占25.0%和10.2%。粘质沙雷菌的标本主要来源于痰液,占71.3%。2012年、2013年、2014年分离的菌株数量逐年增加,分别为29株、31株、48株。2013年与2012年相比,亚胺培南、妥布霉素、庆大霉素、氨曲南耐药性变化明显,而2014年与2013年相比,头孢曲松耐药性变化明显,差异均有统计学意义(P<0.05)。ICU粘质沙雷菌对头孢哌酮舒巴坦、亚胺培南、头孢曲松、哌拉西林他唑巴坦、妥布霉素的耐药率明显高于非ICU菌株,差异有统计学意义(P<0.05)。结论粘质沙雷菌的耐药情况日益严重,ICU的耐药率高于非ICU,根据药敏结果选择恰当的药物进行经验治疗可能有助于改善耐药情况。
Objective To analyze the clinical distribution and drug resistance of Serratia marcescens in hospitals and to guide the clinical experience treatment. Methods 108 strains of Serratia marcescens from January 2012 to December 2014 in our hospital were collected and drug susceptibility test was conducted by K-B method. The clinical distribution and drug resistance were statistically analyzed. Results The 108 strains of Serratia marcescens were the most common in ICU, accounting for 27.8%, followed by neurosurgery and neurology, accounting for 25.0% and 10.2% respectively. Serratia marcescens specimens mainly from sputum, accounting for 71.3%. The number of strains isolated in 2012, 2013 and 2014 increased year by year, which were 29, 31 and 48 respectively. Compared with 2012, the resistance changes of imipenem, tobramycin, gentamicin and aztreonam are obvious in 2013. Compared with 2013, the drug resistance of ceftriaxone changed significantly, The differences were statistically significant (P <0.05). The drug resistance rate of Serratia marcescens to cefoperazone sulbactam, imipenem, ceftriaxone, piperacillin-tazobactam and tobramycin was significantly higher than that of non-ICU strains Significance (P <0.05). Conclusion The drug resistance of Serratia marcescens is becoming more and more serious. The drug resistance rate of ICU is higher than that of non-ICU. Selecting appropriate drugs based on drug susceptibility results may help to improve the drug resistance.