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目的研究2011-2015年某院常见肠杆菌的分离及耐药情况,为临床合理用药提供参考。方法收集该院5年分离的常见肠杆菌,Vitek 2 Compact全自动微生物分析系统结合基质辅助激光解吸电离飞行时间质谱仪(MALDI-TOF)完成细菌鉴定,K-B法进行药敏实验,WHONET 5.6软件数据分析。结果 5年分离常见肠杆菌6 908株,总分离率为44.7%。标本主要为痰液,占39.1%,其次为尿液和伤口拭子,分别占15.3%和7.9%。大肠埃希菌对青霉素类、头孢菌素类或喹诺酮类等药物的耐药率大于50.0%,对酶抑制剂复合制剂和碳青霉烯类药物的耐药率分别低于15.0%和2.0%。产超广谱β-内酰胺酶(Extended-Spectrum Beta-Lactamase,ESBLs)的肺炎克雷伯菌维持在28.4%~34.8%,肺炎克雷伯菌对各类药物的耐药率均小于50.0%。5年间,阴沟肠杆菌的ESBLs阳性率逐年升高,2015年达100.0%,阴沟肠杆菌对青霉素类、磺胺类、头孢菌素类、酶抑制剂复合制剂等药物的耐药率较高;对亚胺培南和美罗培南最为敏感,耐药率在10.0%以下。结论该院近5年分离的常见肠杆菌呈现不同程度耐药,临床治疗应根据药敏结果选择合理的抗菌药物。
Objective To study the isolation and drug resistance of common Enterobacteriaceae in a hospital from 2011 to 2015 and provide a reference for clinical rational drug use. Methods The common Enterobacteriaceae isolated from the hospital for 5 years were collected. The Vitek 2 Compact automatic microbial analysis system combined with matrix-assisted laser desorption / ionization time-of-flight mass spectrometry (MALDI-TOF) was used for bacterial identification. KB method was used for drug susceptibility testing. WHONET 5.6 software data analysis. Results A total of 6 908 strains of Enterobacter were isolated in 5 years. The total isolation rate was 44.7%. The specimens were mainly sputum, accounting for 39.1%, followed by urine and wound swabs, accounting for 15.3% and 7.9% respectively. The resistance rates of Escherichia coli to penicillins, cephalosporins and quinolones were more than 50.0%, and the rates of resistance to enzyme inhibitors and carbapenems were less than 15.0% and 2.0%, respectively. . Klebsiella pneumoniae producing Extended-Spectrum Beta-Lactamase (ESBLs) maintained at 28.4% -34.8%, Klebsiella pneumoniae resistant rate to various drugs were less than 50.0% . In five years, the positive rate of ESBLs in Enterobacter cloacae increased year by year, reaching 100.0% in 2015. The resistance rate of Enterobacter cloacae to penicillins, sulfonamides, cephalosporins and enzyme inhibitor complex preparations was high. Imipenem and Meropenem were the most sensitive, with resistance rates below 10.0%. Conclusion The common Enterobacteriaceae isolated in the past five years showed different degrees of resistance. The clinical treatment should be based on drug susceptibility results to choose a reasonable antibacterial drug.