老年患者阴沟肠杆菌感染的临床特点及耐药性分析

目的了解我院老年患者阴沟肠杆菌感染的临床分布及耐药性变迁,为临床合理用药提供参考依据。方法采用回顾性分析方法,统计临床数据并分析我院2011年9月至2016年4月期间老年患者感染标本中分离出的阴沟肠杆菌的感染现状及耐药性。结果共检出149株阴沟肠杆菌,主要分离于痰液、全血和尿液中,分别占31.54%、24.16%和18.12%。在科室分布中,阴沟肠杆菌感染主要来源于普通外科、重症监护病房和呼吸内科,分别占26.84%、14.10%和14.10%。药敏结果显示阴沟肠杆菌对美罗培南、亚胺培南和阿米卡星具有较好的抗菌活性,敏感率分别为100.00%、96.64%和95.97%,而对阿莫西林/克拉维酸、氨苄西林、头孢替坦、头孢西丁和头孢唑啉的耐药率分别为96.36%、96.36%、97.67%、100.00%和100.00%。结论阴沟肠杆菌易引起呼吸道、泌尿道以及伤口的感染,且其耐药现象较为严重,应加强耐药性的监测,根据药敏结果合理选用抗菌药物,以控制医院感染。

Clinical characteristics and drug resistance of the pathogen in elderly patients with Enterobacter cloacae infection

Abstract: Objective To investigate the clinical distribution and drug resistance of Enterobacter cloacae in elderly patients so as to provide guidance for clinical reasonable use of antibiotics. Methods Aretrospective analysis was carried out to review the clinical data of elderly patients withEnterobacter cloacae infection during Sep. 2011 and Apr. 2016, and the distribution and drug resistance of the pathogen were analyzed. Results A total of 149 strains of Enterobacter cloacae were isolated, mainly from sputum(31.54%), blood (24.16%) and urine(18.12%). Most of these strains were isolated from the general surgery department (26.84%), intensive care unit (14.10%) and respiratory department (14.10%). The pathogen was susceptible to meloxicam,imipenem and amikacin with the drug susceptibility rates of 100%, 96.64% and 95.97% respectively. The drug resistance rates to amoxicillin/clavulanic acid, ampicillin, cefotetan, cefoxitin and cefazolin were 96.36%, 96.36%, 97.67%, 100.00% and 100.00%, respectively. Conclusion Enterobacter cloacaeoften causes infections of respiratory tract, urinary tract and wound, and is highly resistant to antibacterial drugs. It is necessary to strengthen the monitoring of drug resistance and choose antibiotics rationally based on susceptibility test results so as to control the incidence of nosocomial infections.