血液透析患者感染的菌群分布和耐药性分析

目的了解引起血液透析感染菌群分布及耐药情况。方法用K-B法进行药敏试验,对革兰阴性菌采用ESBLs确认试验检测ESBLs,头孢西丁三维试验检测AmpC。结果本组分离的259株细菌中,革兰阴性菌179株,占69.1%,主要致病菌为大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌。革兰阳性菌80株,占30.9%,以金黄色葡萄球菌、凝固酶阴性葡萄球菌居前2位。革兰阴性杆菌ESBLs、AmpC酶总检出率分别为42.4%、39.1%,单产ESBLs、单产AmpC、同产ESBLs 高产AmpC酶、ESBLs 诱导AmpC酶菌株依次占15.6%、12.3%、16.8%、10.1%。革兰阳性分离株除对万古霉素、替考拉宁、喹奴普汀-达福普汀、利福平的耐药率较低外,其余抗生素的耐药率均大于50.0%。革兰阴性分离株对亚胺培南、美罗培南、头孢哌酮/他唑巴坦的耐药率分别为5.02%、3.35%和6.70%,产酶株较非产酶株具有较高的耐药率。结论血液透析患者细菌感染以金黄色葡萄球菌、凝固酶阴性葡萄球菌、大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌为主,万古霉素、替考拉宁对革兰阳性菌,亚胺培南、美罗培南和头孢哌酮/他唑巴坦对革兰阴性菌具有良好的抗菌活性。

The distributing and insecticide tolerance analyse of flora that cause infection on hemodialysis sufferer

Objective To know the distributing and insecticide tolerance of flora which course the infection on hemodialysis sufferer.Methods Drug sensitive test by K-B coating,detected ESBLs by ESBLs affirm test and detected AmpC by Cefoxitin three dimensional test during G-bacterium.Results During the 259 bacteriums which separated from this group,179 strains were G-(69.1%),primary pathogenic bacteria of that were E.coli,K.pneumoniae,Enterobacter cloacae,at the same time,80 strains were G (30.9%),ahead of them were Staphylococcus aureus and coagulase-negative staphylococci(CNS).The detectable rate of ESBLs and AmpC were 42.4% and 39.1% in G-,thereinto,single birth of ESBLs occupied 15.6%,that of AmpC was 12.3%,high yield AmpC amalgamated ESBLs occupied 16.8%,and inducement AmpC amalgamated ESBLs occupied 10.1%.Otherwise,the rate of tolerance of antibiotics were all higher than 50% except VAN,TEC,QDA and Rifampin in G .The rate of tolerance to IPM,MEM,CSL were 5.02%,3.35%,6.70% separately in G-,and the enzyme-procreant G-were much moredrug toleranced than that without enzyme.Conclusions Basically,pathogenic bacteria which caused infection on hemodialysis sufferer were Staphylococcus aureus,coagulase-negative staphylococci(CNS),E.coli,K.pneumoniae,and Enterobacter cloacae,it was more nicer antibiotic effect that VAN and TEC to G ,IPM,MEM and CSL to G-.