Objective:To investigate the incidence of the clinical isolates gram-negative bacilli and monitor the drug resistance surveillance.Methods:Collecting a total of 5548 non-duplicate clinical isolates of Gram-negative bacteria in 2011-2012.The identification of bacteria and susceptibility test were performed using VITEK2 automatic bacteria idenificator.Results:Pseudomonas aeruginosa(32.7%),escherichia coli(23.6%),acinetobacter baumannii(23.0%),pneumonia gramsReber bacteria (6.9%),proteus mirabilis(5.3%) were most frequently isolated.Escherichia coli,klebsiella pneumoniae,proteus mirabilis in ESBLs positive rate were 48.4%,31.8%and 13.4%,ESBLs producing strains were the important pathogens of nosocomial infection;Imipenem and meropenem resistant strains were not found.The susceptibility rates of pseudomonas aeruginosa to meropenem,imipenem,cefoperazone-sulbactam,amikacin,tobramycin,piperacillin-tazobactam respectively were 81.3%,79.3%,77.0%,67.2%,63.9%,60.9%.The susceptibility rate of Baumanil to minocycline,and cefoperazone-sulbactam were 30.4%and 48.2%.The other antibiotics resistance rate were above 80.0%.Conclusion:Compared to 2010,acinetobacter baumannii is increased,amomn these isolation strains and mostly came from ICU,the sensitive rates of acinetobacter baumannii to imine-south and meropenem is decline,pan-resistant strains account for about 80.0%and drug resistance is serious,a growing trend of the clinical isolates Gram-negative bacilli to common biotics was showed.The detection rate of ESBLs,CRPA and CRAB is increasing significantly.It is the most important and valuable to strength the rational selection of antimicrobial agents and control the nosocomial infections.% 目的：了解医院临床分离革兰氏阴性杆菌的发生率，并进行耐药监测。方法：收集2011-2012年笔者所在医院非重复临床分离革兰阴性菌5548株，VITEK2全自动细菌鉴定仪进行菌株鉴定和药敏试验。结果：医院院内感染革兰氏阴性杆菌前5位病原菌依次为铜绿假单胞菌(32.7%)、大肠埃希菌(23.6%)、鲍曼不动杆菌(23.0%)、肺炎克雷伯菌(6.9%)、奇异变形杆菌(5.3%)。大肠埃希菌、肺炎克雷伯菌、奇异变形杆菌中产ESBLs阳性率分别为48.4%、31.8%和13.4%，未发现对亚胺培南和美罗培南耐药的菌株。铜绿假单胞菌对美罗培南、亚胺培南、头孢哌酮-舒巴坦、阿米卡星、妥布霉素、哌拉西林-他唑巴坦的敏感率为81.3%、79.3%、77.0%、67.2%、63.9%、60.9%。鲍曼不动杆菌仅对米诺环素、头孢哌酮-舒巴坦耐药，耐药率为30.4%和48.2%，其他抗菌药物耐药率均在80.0%以上。结论：本次分离菌中鲍曼不动杆菌较2010年前有所增多，且大多来自ICU，鲍曼不动杆菌对亚胺培南和美罗培南的敏感率下降，泛耐株约占80.0%，耐药状况严重。临床分离革兰氏阴性杆菌对常用抗菌药物耐药性呈增长趋势，ESBLs、CRPA、CRAB检出率增加显著，应加强抗生素的合理使用和医院感染控制。
展开▼
