所有菌株均从腹腔感染病人感染部位分必物培养获得，腹腔感染包括.doc

腹腔感染革兰阴性细菌耐药性临床分析400016 重庆，重庆医科大学附属第一医院感染科，重庆市传染病寄生虫病学重点实验室1；402160重庆，重庆医科大学附属永川医院2008-2010年临床分离的非重复腹腔感染革兰阴性菌的流行病学特点, 对常用抗菌药物的耐药性以及产ESBLs比例，为指导临床治疗提供支持。 方法 药敏试验采用琼脂稀释法测定MIC；用WHONET 5.4软件及SPSS 13.0软件进行数据分析。 结果 临床分离的290株革兰阴性菌病原菌中，肠杆菌科细菌占82.07%；非发酵菌为17.93％。常见细菌有6种，其中大肠埃希菌占55.3%，鲍曼不动杆菌复合群所占比例明显升高(7.96%)。大肠埃希菌和肺炎克雷伯菌产ESBLs阳性率分别为74.38%和55.56%。大肠埃希菌对碳青霉烯类、派拉西林/他唑巴坦和阿米卡星高度敏感，但第3代头孢菌素和头孢吡肟耐药率很高。非ESBLs产酶肺炎克雷伯菌对常见12种抗G-细菌抗菌药物都很敏感,产ESBL菌株则对阿米卡星、派拉西林/他唑巴坦和碳青霉烯类比较敏感。铜绿假单胞菌对亚胺培南（MDR ） MDR几乎对所有临床常用抗菌药物耐药。 结论 本地区腹腔感染革兰阴性菌对常用抗菌药物耐药性明显上升，产ESBLs肠杆菌细菌比例较高。肠杆菌细菌和铜绿假单胞菌对碳青霉烯类、派拉西林/他唑巴坦和阿米卡星敏感性高；鲍曼不动杆菌对常用抗菌药物耐药性很严重，泛耐药菌株比例上升。 [关键词] 腹腔感染； 耐药监测；革兰阴性菌；抗感染治疗 [中图法分类号] R378 [文献标志码] A Clinical characteristics of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections Tian Wenguang1 Huang Wenqiang2 Jia Bei2 Xin Xiaojuan2 Li Congzhi2 Zheng Xingping 2(1Infection department of the Yongchuan Affiliated Hospital ,Chongqing Medical University,Chongqing, 402160；2Infection department of the First Affiliated Hospital ,Chongqing Medical University, Chongqing, 40016) [Abstract] Objective The study was to investigate antimicrobial resistance trends among aerobic and facultative Gram-negative bacilli (GNB) isolated from intra-abdominal infections at a teaching hospital between 2008 to 2010. Methods to collecte gram-negative bacilli from patients with intra-abdominal infections from 2008 to 2010 . Antimicrobial susceptibility testing was performed using broth microdilution according to the NCCLS guidelines for MIC testing, and Extended-spectrum beta-lactamases (ESBLs) were detected phenotypically in E. coli and Klebsiella spp. Results A total of 290 aerobic and facultative GNB were isolated from intra-abdominal infections. Enterobacteriaceae composed 82.7% of the total isolates. E. coli was the most common isolate (55.3%), and the rato of Acinetobacter baumannii Complex incereasing apprently. ESBLs were detected phe