论文部分内容阅读
目的了解昆明市级医院阴沟肠杆菌多药耐药菌株的院内垂直传播现状。方法采用美国临床实验室标准化研究所(CLSI)推荐的K-B法药敏试验检测昆明市第一人民医院2002年7月-2004年6月临床分离阴沟肠杆菌的耐药表型;脉冲场凝胶电泳(PFGE)分析耐药菌株的克隆传播状况。结果第一、二代头孢菌素的耐药率>80.0%;三代头孢菌素除头孢他啶外,耐药率均>70.0%;头孢吡肟的耐药率为31.5%;头霉素类的耐药率>65.0%;亚胺培南100.0%敏感;β-内酰胺酶抑制剂复合制剂耐药率为50.0%~90.0%;庆大霉素耐药率高达66.7%,而阿米卡星耐药率只有14.1%;环丙沙星耐药率为48.4%;复方新诺明耐药率为64.8%;ICU分离的14株阴沟肠杆菌中7株具有相同PFGE指纹。结论昆明市第一人民医院临床分离阴沟肠杆菌多药耐药严重,存在耐药菌株的垂直传播。
Objective To understand the vertical transmission of multidrug-resistant strains of Enterobacter cloacae in Kunming Municipal Hospital. Methods The susceptibility of Enterobacter cloacae isolated from First People’s Hospital of Kunming from July 2002 to June 2004 was detected by KB method recommended by Clinical Laboratory Standards Institute (CLSI). The pulsed field gel Electrophoresis (PFGE) analysis of drug-resistant strains of cloned transmission. Results The resistance rates of the first and second generation cephalosporins were> 80.0%. The third generation cephalosporins except ceftazidime were resistant to> 70.0% and the resistant rate to cefepime was 31.5% The drug resistance rate was 65.0%, imipenem 100.0%, the drug resistance rate of β-lactamase inhibitor was 50.0% -90.0%, the rate of gentamycin was as high as 66.7%, and the rate of amikacin The drug resistance rate was only 14.1%; the rate of ciprofloxacin was 48.4%; the rate of cotrimoxazole resistance was 64.8%; and among the 14 strains of Enterobacter cloacae isolated by ICU, 7 strains had the same PFGE fingerprint. Conclusion The clinical isolates of Enterobacter cloacae in Kunming First People’s Hospital have serious multi-drug resistance and vertical transmission of drug-resistant strains.