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目的了解常见病原菌对左旋氧氟沙星的耐药性变化趋势,为临床合理应用喹诺酮类药物提供参考。方法收集郑州大学第一附属医院2011年1月-2016年6月细菌室分离的49 946株不重复菌株,进行回顾性分析,探讨常见病原菌对左旋氧氟沙星的耐药性变迁。结果金黄色葡萄球菌和凝固酶阴性的葡萄球菌是革兰阳性菌感染的主要病原菌(约52.00%),大肠埃希菌、肺炎克雷伯菌是最常见的肠杆菌科细菌(占整个阴性杆菌45.10%),铜绿假单胞菌、鲍曼不动杆菌在非发酵菌感染中占绝对优势(占整个阴性杆菌28.10%)。6年间几种常见病原菌对左旋氧氟沙星总耐药率为53.66%。大肠埃希菌耐药性最严重,为70.11%,其次为鲍曼不动杆菌,耐药率60.86%;金葡菌耐药性呈显著下降趋势,由2011年61.55%降至2016年的41.12%,凝固酶阴性的葡萄球菌始终保持在55%以上;肺炎克雷伯菌与铜绿假单胞菌对左旋氧氟沙星耐药率相对较低,其敏感性均保持在60%左右。结论大肠埃希菌、鲍曼不动杆菌对于喹诺酮类药物具有广泛耐药性,临床应加强此类菌株感染治疗的指导与监测。
Objective To understand the trend of resistance of common pathogens to levofloxacin and provide a reference for the rational application of quinolones. Methods A total of 49 946 non-repetitive strains isolated from the bacteria room in the First Affiliated Hospital of Zhengzhou University from January 2011 to June 2016 were retrospectively analyzed to investigate the resistance changes of common pathogens to levofloxacin. Results Staphylococcus aureus and coagulase-negative Staphylococcus aureus were the main pathogens of Gram-positive bacteria infection (about 52.00%). Escherichia coli and Klebsiella pneumoniae were the most common Enterobacteriaceae bacteria (accounting for the entire negative bacilli 45.10%), Pseudomonas aeruginosa and Acinetobacter baumannii accounted for the absolute superiority in non-fermentative bacteria infection (accounting for 28.10% of the total negative bacilli). The total resistance rate of several common pathogens to levofloxacin in 6 years was 53.66%. Escherichia coli was the most resistant, 70.11%, followed by Acinetobacter baumannii, the resistance rate was 60.86%; Staphylococcus aureus drug resistance showed a significant downward trend from 61.55% in 2011 to 41.12 in 2016 %, Coagulase-negative Staphylococcus aureus remained above 55%; Klebsiella pneumoniae and Pseudomonas aeruginosa on levofloxacin relatively low resistance rate, the sensitivity remained at about 60%. Conclusion Escherichia coli and Acinetobacter baumannii have wide range of resistance to quinolones, and should be used to guide and monitor the infection treatment of these strains.