Abstract：Objective To study the distribution and drug resistance of main gram-negative bacilli causing nosocomial infections in a certain hospital, so as to provide scientific basis for the infection control and reasonable use of antibiotics in clinics. Methods The main strains were collected from patients’ specimens in this hospital from 2011-2014 .The bacterial identification and drug susceptibility tests were performed and their drug resistance was retrospectively analyzed. Results A total of 12437 gram-negative isolates were collected from non- repetitive clinical specimens during the past four years,of which Enterobacteriaceae and non-fermentative Gram- negative bacilli accounted for 6243(50.2%) and 5920(47.6%), respectively. The Acinetobacter,Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli were the predominant species of Gram-negative bacilli,accounted for 21.1%,19.4%,16.8% and 8.5% respectively. The source of pathogenic bacteria specimens were mainly from respiratory tract and followed by urinary tract. Infection with high-risk departments were the brain injury rehabilitation department and ICU. By monitoring multi-drug resistant bacteria during four consecutive years,it was found that ESBLs-producing Escherichia coli and Klebsiella pneumoniae(64.9%,64.3%,62.1%,55.4%),(50.1%,47.7%,43.4%,45.7%) showed a trend of decline.But carbapenem- resistant Escherichia coli and Klebsiella pneumoniae(0.8%,1.5%,1.3%,2.6%),(17.4%,30.8%,27.1%,34.1%) had a rising trend year by year. During the past four years, the average detection rate of extensively drug-resistant Acinetobacter was 40.3%. Conclusions Most clinical isolates are Gram-negative bacilli and multi-drug resistant strains increase obviously.The reasonable clinical use of antibiotics is crucial for delay of emergence of drug-resistant strains. It is also necessary to strengthen the surveillance of drug resistance of the pathogens and prevent the spread of MDRO causing nosocomial infection.
黄永高, 陈然峰, 孙龙. 某医院2011-2014年临床分离革兰阴性杆菌分布及耐药性分析[J]. 武警医学, 2015, 26(7): 702-706.
HUANG Yonggao, CHEN Ranfeng, SUN Long. Analysis of distribution and drug resistance of gram-negative bacilli causing nosocomial infections from 2011 to 2014 in a hospital. Med. J. Chin. Peop. Armed Poli. Forc., 2015, 26(7): 702-706.
Lee N Y, Wang C L, Chuang Y C, et al. Combination carbapenem-sulbactam therapy for critically ill patients with multidrug-resistant Acinetobacter baumannii bacteremia: four case reports and an in vitro combination synergy study[J]. Pharmacotherapy, 2007,27:1506-1511.
Kiffer C R,Sampaio J L, Sinto S,et al.In vitro synergy test of meropenem and sulbactam against clinical isolates of Acinetobacter baumannii[J].Diagn Microbiol Infect Dis, 2005, 52:317-322.
Petersen P J, Labthavikul P, Jones C H, et al. In vitro antibacterial activities of tigecycline in combination with other antimicrobial agents determined by chequerboard and time-kill kinetic analysis[J]. J Antimicrob Chemother, 2006, 57:573-576.
[3]
Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing[S]. Twenty-forth informational supplement,2014,M100-S24 Vol 34 No.1.
Zhang R,Zhou H W,Cai J C,et al.Plasmid-mediated carbapenem-hydrolysing beta-lactamase KPC-2 in carbapenem-resistant Serratia marcescens isolates from Hangzhou, China[J]. J Antimicrob Chemother, 2007, 59(3):574-576.
[11]
Wei Z Q, Du X X, Yu Y S, et al. Plasmid-mediated KPC-2 in a Klebsiella pneumoniae isolate from China[J]. Antimicrob Agents Chemother, 2007, 51(2): 763-765.
[12]
Cai J C, Zhou H W, Zhang R, et al. Emergence of Serratia marcescens, Klebsiella pneumoniae,and Escherichia coli Isolates possessing the plasmid-mediated carbapenemhydrolyzing beta- lactamase KPC-2 in intensive care units of a Chinese hospital[J]. Antimicrob Agents Chemother, 2008,52(6):2014-2018.
[13]
Lee N Y, Wang C L, Chuang Y C, et al. Combination carbapenem-sulbactam therapy for critically ill patients with multidrug-resistant Acinetobacter baumannii bacteremia: four case reports and an in vitro combination synergy study[J]. Pharmacotherapy, 2007,27:1506-1511.
[14]
Kiffer C R,Sampaio J L, Sinto S,et al.In vitro synergy test of meropenem and sulbactam against clinical isolates of Acinetobacter baumannii[J].Diagn Microbiol Infect Dis, 2005, 52:317-322.
[15]
Petersen P J, Labthavikul P, Jones C H, et al. In vitro antibacterial activities of tigecycline in combination with other antimicrobial agents determined by chequerboard and time-kill kinetic analysis[J]. J Antimicrob Chemother, 2006, 57:573-576.
2015, Vol. 26 
