论文部分内容阅读
目的：分析临床分离5796株革兰氏阴性杆菌分布及其耐药性变迁。方法美国实验室标准协会（ CLSI ）2013版为标准判定药敏试验结果，用WHONET 5.6软件对数据分析。结果共收集5796株革兰氏阴性杆菌。2009年至2012年铜绿假单胞菌耐药率整体呈上升趋势，2013年有所下降。对铜绿假单胞菌耐药率最高的是替卡西林／克拉维酸（33.7％），对多数常用抗菌药耐药率低于20％。鲍曼不动杆菌的耐药率明显升高，鲍曼不动杆菌对亚胺培南耐药率由10％升高到60.8％，美罗培南由9.8％升高到60.8％，仅米诺环素、头孢哌酮／舒巴坦对其具有较好的活性。肠杆菌科细菌耐药率变化趋势不明显，对碳青霉烯类抗菌药物的敏感率大于97％。产超广谱β内酰胺酶（ ESBLs）大肠埃希菌和肺炎克雷伯菌的检出率分别为59.7％和36.8％。结论铜绿假单胞菌和鲍曼不动杆菌耐药率呈上升趋势，已检出碳青霉烯类不敏感的肠杆菌科细菌。“,”Objective To investigate the characteristics of distribution and the diversity of drug resistance of 5796 gram-negative clinical iso-lates collected from the Jinan Central Hospital affiliated to Shandong Uni-versity from 2009 to 2013.Methods Results were analyzed according to the breakpoints of CLSI 2013.The clinical data were reviewed retrospec-tively by software WHONET 5.6.Results A totle of 5796 gram -negative clinical isolates were analysised.The antibiotics resistance rates of Pseudomonas aeruginosa isolates overall kept an increasing tendency from 2009 to 2012 , but the majority of them showed an downward trend in 2013.The 33.7%of the Pseudomonas aeruginosa isolates showed the highest resistance to ticarcililin -clavulanate.Less than 20% of the Pseudomonas aeruginosa strains were resistant to most of the antimicrobial agents.The antibiotics resistance rates of Acinetobacter baumannii strains obviously increased during the past five years.Imipenem increased from 10% to 60.8%.Meropenem increased from 9.8% to 60.8%.Acineto-bacter baumannii strains were relatively susceptible to minocycline and ce-foperazone/sulbactam.ESBLs were produced in 59.7% of the Escherichia coli strains, in 36.8%of the Klebsilla pneumoniae strains.97%of the En-terobacteriaceae strains were still sensitive to carbapenem antibiotics.Conclusion The antibiotics resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii kept an increasing tendency.Carbapenem non-susceptible Enterobacteriaceae strains had appeared.