摘要
目的对阴沟肠杆菌的临床分布及耐药情况进行探讨,为抗菌药物的合理使用及医院感染的防控提供参考。方法收集2015年—2018年某综合医院临床标本分离的阴沟肠杆菌,对其临床分布特征及耐药情况进行统计分析。结果共分离出阴沟肠杆菌195株,主要来自于住院患者(98.5%),以儿科检出率最多(36.9%),其次是神经外科(13.3%)及ICU(12.3%)。标本类型以痰液和分泌物为主,分别占69.2%、15.4%。阴沟肠杆菌对头孢唑啉、头孢替坦耐药率>90.0%,对阿米卡星的耐药率最低(1.5%);对头孢吡肟、环丙沙星、哌拉西林/三唑巴坦、左氧氟沙星、亚胺培南和厄他培南的耐药率<10.0%。不同病区和不同标本类型分离阴沟肠杆菌对抗菌药物的耐药情况不同,ICU病区耐药情况最为严重,神经外科病区次之,儿科病区耐药性普遍较低;除头孢唑啉和头孢替坦外,分离自尿液标本菌株对其他抗菌药物的耐药率高于痰液和分泌物标本来源菌株。结论该综合医院阴沟肠杆菌的分离率趋于稳定,阴沟肠杆菌对多种抗菌药物耐药性呈现下降趋势,不同病区、不同标本类型分离阴沟肠杆菌的耐药性具有较大差异,临床应及时进行细菌培养,根据病区耐药性的特点,合理选用抗菌药物。儿科、ICU及神经外科病区是预防控制的重点科室,应予以高度关注。
Objective To investigate the clinical distribution and drug resistance of Enterobacter cloacae,and to provide a reference for the rational use of antibacterial drugs and the prevention and control of nosocomial infections.Methods Collectind and statistical analysis were adopted to conducted retrospective analysis on the clinical distribution characteristics and drug resistance of Enterobacter cloacae isolated from clinical specimens of general hospital from 2015 to 2018.Results 195 isolates of Enterobacter cloacae were isolated,mainly from inpatients(98.5%),with the highest detection rate in pediatrics(36.9%),followed by neurosurgery(13.3%)and ICU(12.3%).The type of specimens was mainly sputum and secretions,accounting for 69.2%and 15.4%,respectively.The resistance rate of Enterobacter cloacae to cefazolin and cefotetan was more than 90.0%,and it was resistant to amikacin has the lowest resistance rate(1.5%);The resistance rates to cefepime,ciprofloxacin,piperacillin/tazobactam,levofloxacin,imipenem,and ertapenem are less than 10.0%.The drug resistance of Enterobacter cloacae isolated from different wards or of different specimen types was distinct.The resistance rate in ICU ward was the highest,followed by the neurosurgery ward and the resistance rate in pediatric ward was generally low,Specimen strains isolated from Urine had a higher resistance rate against antibacterial drugs than the sputum and secretion source strains except cefazolin and cefotetan.Conclusion The isolation rate of Enterobacter cloacae in this general hospital has stabilized,and the resistance of Enterobacter cloacae to multiple antibacterial drugs has shown a downward trend.Isolation in different disease areas and different specimen types Enterobacter cloacae has large differences in drug resistance,and bacterial culture should be carried out in the clinic in a timely manner.Antibacterial drugs should be reasonably selected according to the characteristics of drug resistance in the ward.Pediatrics,ICU,and neurosurgery wards are key departments for prevention and control and should be highly anticipated.
作者
赵德军
田兴华
Zhao De-jun;Tian Xing-hua(The First People’s Hospital of Qingzhen City,Qingzhen 551400)
出处
《国外医药（抗生素分册）》
CAS
2020年第2期149-153,共5页
World Notes on Antibiotics
关键词
阴沟肠杆菌
耐药性
监测
抗菌药物
Enterobacter cloacae
drug resistance
surveillance
antibacterials
