该院2017年肠杆菌细菌的分布及耐药性研究(1)
[摘要] 目的 探讨该院2017年肠杆菌科细菌分布及耐药情况，为肠杆菌科细菌感染抗菌药物临床合理防治提供依据参考。方法 以2017年1—12月该院检验科细菌室按照患者首次分离菌株去除重复菌株分离的401株肠杆菌科细菌为研究对象，观察细菌种类及分布，K-B纸片法检测菌株抗菌药物敏感性，观察耐药情况。结果 401株肠杆菌科细菌中，肺炎克雷伯菌148株(36.91%)，大肠埃希菌128株(31.92%)，产气肠杆菌、粘质沙雷菌各28株(6.98%)，阴沟肠杆菌16株(3.99%)。肺炎克雷伯菌主要来自痰标本，构成比81.08%，对哌拉西林、氨苄西林//舒巴坦、头孢呋辛等耐药，对阿米卡星、美洛培南、亚胺培南、头孢西丁等敏感；大肠埃希菌主要来自尿标本，构成比55.47%，对哌拉西林、氨苄西林、四环素等耐药，对亚胺培南、美洛培南、阿米卡星等敏感。结论 该院肠杆菌科细菌分布广、种类多，以肺炎克雷伯菌和大肠埃希菌分离率最高，两者均存在不同程度耐药，应引起临床重视，加强耐药监测，合理应用抗菌药物控制耐药菌医源性感染，保障医疗安全。
[关键词] 肠杆菌科细菌；感染分布；耐药性
[中图分类号] R446 [文献标识码] A [文章编号] 1674-0742(2018)10(c)-0049-03
[Abstract] Objective To investigate the distribution and drug resistance of Enterobacteriaceae in our hospital in 2017， and provide reference for clinical rational prevention and treatment of bacterial infection of Enterobacteriaceae. Methods From January to December 2017， the 401 strains of Enterobacteriaceae isolated from the isolates of the first isolates of our hospital were used as the research object to observe the bacterial species and distribution. The KB method was used to detect the strains drug sensitivity， observe drug resistance. Results Among 401 strains of Enterobacteriaceae， 148 strains of Klebsiella pneumoniae (36.91%)， 128 strains of Escherichia coli (31.92%)， 28 strains of Enterobacter aerogenes and Serratia marcescens (6.98%)， 16 strains of Enterobacter cloacae (3.99%). Klebsiella pneumoniae was mainly from sputum specimens， which constitutes 81.08%， resistant to piperacillin， ampicillin//sulbactam， cefuroxime， etc， for amikacin， meropenem， imipenem sensitive to cefoxitin； Escherichia coli mainly from urine samples， the composition ratio was 55.47%， resistant to piperacillin， ampicillin， tetracycline， etc， to imipenem， meropenem， amikacin， etc. sensitive. Conclusion The bacteria of Enterobacteriaceae in our hospital are widely distributed and various types. The isolation rate of Klebsiella pneumoniae and Escherichia coli is the highest. Both of them have different degrees of drug resistance. It should be paid attention to clinically， strengthen drug resistance monitoring and rationally apply antibacterial. The drug controls the iatrogenic infection of drug-resistant bacteria to ensure medical safety.
[Key words] Enterobacteriaceae bacteria； Infection distribution； Drug resistance
腸杆菌科是生存于人和动物肠道中的生物学性状相同或相似的一类革兰阴性杆菌，现已知菌属30余个，菌种120多，其中多数为肠道正常菌群，少数为致病菌，是人类肠传染病重要致病菌，也可引起呼吸道、泌尿系、血液等多系统感染[1]。2016年全国CHINET细菌耐药性监测数据显示，肠杆菌科细菌分离率居各科致病菌首位，已经成为导致医院感染的最主要条件致病菌[2]。受广谱抗菌药物不规范使用等因素影响，肠杆菌科细菌耐药问题近年较为突出，掌握耐药菌临床分布及耐药谱变化对肠杆菌科细菌耐药控制及有效感染治疗具有重要意义[3]。文章现以2017年1—12月该院401株肠杆菌科菌株样本为例，对其临床分布及耐药情况进行分析探讨，现报道如下。, http://www.100md.com(栾和伟)
[关键词] 肠杆菌科细菌；感染分布；耐药性
[中图分类号] R446 [文献标识码] A [文章编号] 1674-0742(2018)10(c)-0049-03
[Abstract] Objective To investigate the distribution and drug resistance of Enterobacteriaceae in our hospital in 2017， and provide reference for clinical rational prevention and treatment of bacterial infection of Enterobacteriaceae. Methods From January to December 2017， the 401 strains of Enterobacteriaceae isolated from the isolates of the first isolates of our hospital were used as the research object to observe the bacterial species and distribution. The KB method was used to detect the strains drug sensitivity， observe drug resistance. Results Among 401 strains of Enterobacteriaceae， 148 strains of Klebsiella pneumoniae (36.91%)， 128 strains of Escherichia coli (31.92%)， 28 strains of Enterobacter aerogenes and Serratia marcescens (6.98%)， 16 strains of Enterobacter cloacae (3.99%). Klebsiella pneumoniae was mainly from sputum specimens， which constitutes 81.08%， resistant to piperacillin， ampicillin//sulbactam， cefuroxime， etc， for amikacin， meropenem， imipenem sensitive to cefoxitin； Escherichia coli mainly from urine samples， the composition ratio was 55.47%， resistant to piperacillin， ampicillin， tetracycline， etc， to imipenem， meropenem， amikacin， etc. sensitive. Conclusion The bacteria of Enterobacteriaceae in our hospital are widely distributed and various types. The isolation rate of Klebsiella pneumoniae and Escherichia coli is the highest. Both of them have different degrees of drug resistance. It should be paid attention to clinically， strengthen drug resistance monitoring and rationally apply antibacterial. The drug controls the iatrogenic infection of drug-resistant bacteria to ensure medical safety.
[Key words] Enterobacteriaceae bacteria； Infection distribution； Drug resistance
腸杆菌科是生存于人和动物肠道中的生物学性状相同或相似的一类革兰阴性杆菌，现已知菌属30余个，菌种120多，其中多数为肠道正常菌群，少数为致病菌，是人类肠传染病重要致病菌，也可引起呼吸道、泌尿系、血液等多系统感染[1]。2016年全国CHINET细菌耐药性监测数据显示，肠杆菌科细菌分离率居各科致病菌首位，已经成为导致医院感染的最主要条件致病菌[2]。受广谱抗菌药物不规范使用等因素影响，肠杆菌科细菌耐药问题近年较为突出，掌握耐药菌临床分布及耐药谱变化对肠杆菌科细菌耐药控制及有效感染治疗具有重要意义[3]。文章现以2017年1—12月该院401株肠杆菌科菌株样本为例，对其临床分布及耐药情况进行分析探讨，现报道如下。, http://www.100md.com(栾和伟)