尿液中奇异变形杆菌耐药性变迁及监测分析

目的了解尿液中奇异变形杆菌临床分布及耐药性变迁情况，为临床医生合理选用抗生素提供理论依据。方法收集2008年至2012年住院及门诊患者尿液标本中分离的215株奇异变形杆菌，采用VITEK2 Compact全自动微生物分析仪进行鉴定及药敏试验,采用WH0NET 5.4软件进行统计分析。结果2008、2009、2010、2011和2012年分离奇异变形杆菌分别为26株（占12. 2% ）、26株（占12.2% ）、36株（占16. 9% ）、55株（占25. 8% ）和72株（占33. 8% ），总计215株。奇异变形杆菌对呋喃妥因的耐药率最高，均〉90%，对丁胺卡那霉素和美洛培南的耐药率最低，均为0%，对左旋氧氟沙星的耐药率在2008？2011年均〉50% ,2012年为28.1% ;对哌拉西林/他唑巴坦的耐药率在2008 - 2009年均〉20%，而2010-2012年均〈5% ;头孢替坦、舒普深耐药率均〈7%。结论奇异变形杆菌的分离率从2008 -2012年呈日益增长趋势，提醒我们随着临床上大量使用抗生素，医院的感染率亦不断上升。耐药率从2008-2011年基本呈上升趋势，而在2012年有所下降,这可能与近几年本院临床严格执行抗菌药物的合理应用有关。

Variation of drug resistance of Proteus mirabilis isolated from urine

Objective To study the clinical distribution and drug resistance of Proteus mirabilis isolated from urine, and provideguidance for clinical application of drug. Methods Collected from 2008 - 2012 hospitalization and outpatient urine specimens were isolated 215 strains of Proteus mirabilis,adopting VITEK 2 Compact automatic analyzer for identification and drug sensitive test, WHONET 5.4 software was used for statistical analysis. Results In 2008,2009,2010,2011 and 2012,the seperation from shows that Proteus mira-bilis were 26 strain （12. 2% ）,26 strain （12. 2% ）,36 strain （16. 9% ）,55 strain （25. 8% ） and 72 strain （33. 8% ）,respectively, atotal of 215 strains. The drug resistance rate of Proteus mirabilis in 2008 - 2012 to nitrofurantoin 〉 90%,to amikacin and meropenemwere lowest, both 0%,to levofloxacin from 2008 to 2011 year 〉 50% , 28. 1% in 2012 ; to piperacillin/tazobactam from 2008 to 2009 〉 20%,and 2010 to 2012 annual 〈5% ; to cefotetan, sulperazon 〈1% . Conclusion Proteus mirabilis separation rate from 2008 to 2012is in a growing trend,this trend reminds us that along with the extensive use of antibiotics clinically,make the hospital infection rateshowed a trend of rising. During 2008-2011, the trend is rising, while in 2012, it start to decline. This may be related to our hospital carry out the Reasonable application of antibiotics strictly in recent years.