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·临床检验·中国医药导报 2017 年 11 月第 14 卷第 31 期CHINA MEDICAL HERALD Vol. 14 No. 31 November 20172012~2015年我院院内感染奇异变形杆菌的分布及耐药性变迁于波心1张亚杰2刘 丹1李 强3王佳贺11. 中国医科大学附属盛京医院老年病科，辽宁沈阳 110004 ； 2. 中国医科大学附属盛京医院急诊科，辽宁沈阳110004 ； 3. 中国医科大学附属盛京医院检验科，辽宁沈阳 110004[ 摘要 ] 目的 分析中国医科大学附属盛京医院（以下简称“我院”）院内感染的奇异变形杆菌的分布及耐药性变迁，为临床合理应用抗生素提供参考依据。 方法 回顾性研究 2012 年 1 月 1 日 ~2015 年 12 月 31 日我院奇异变形杆菌院内感染患者的临床数据，分析其临床分布及耐药情况。 结果 共检出 266 株奇异变形杆菌，标本主要来源于尿液（ 57.89% ），其次为分泌物（ 9.02% ）、引流液（ 7.89% ）、痰液（ 7.89% ）、脓汁（ 7.14% ）、全血（ 3.76% ）等。 科室分布以泌尿外科奇异变形杆菌检出率最高（ 19.92% ），其次为 ICU （ 12.78% ）和康复科（ 10.53% ）。 奇异变形杆菌对呋喃妥因、四环素的耐药率极高，均大于 90.0% ，对替卡西林 / 克拉维酸、厄他培南的耐药率 4 年均为 0 。 对头孢唑啉的耐药率上升最显著，从 54.55% 上升至 92.59% ；对头孢他啶、头孢吡肟耐药率 4 年连续下降，分别从 33.33% 、 36.11%降至 3.70% 、 7.32% 。 结论 2012~2015 年我院奇异变形杆菌的分离率呈增长趋势，提示随着临床上大量使用抗生素，医院的感染率亦上升。 奇异变形杆菌对不同的抗生素耐药性不同，监测院内奇异变形杆菌的耐药性及其变迁对临床合理用药有重要指导作用。[ 关键词 ] 奇异变形杆菌；感染；临床分布；耐药[ 中图分类号 ] R378 [ 文献标识码 ] A [ 文章编号 ] 1673-7210 （ 2017 ） 11 （ a ） -0116-04Clinical distribution and change of drug resistance of Proteus mirabiliscausing nosocomial infections in our hospital from 2012 to 2015YU Boxin 1 ZHANG Yajie 2 LIU Dan 1 LI Qiang 3 WANG Jiahe 11.Department of Geriatrics, Shengjing Hospital of China Medical University, Liaoning Province, Shenyang 110004,China; 2.Department of Emergency, Shengjing Hospital of China Medical University, Liaoning Province, Shenyang110004, China; 3.Department of Laboratory Medicine, Shengjing Hospital of China Medical University, LiaoningProvince, Shenyang 110004, China[Abstract] Objective To analyze the clinical distribution and drug resistance of Proteus mirabilis causing nosocomialinfections in Shengjing Hospital of China Medical University ( “ our hospital ” for short), in order to provide evidence forchoosing antibiotics reasonably. Methods The clinical distribution and drug resistance of Proteus mirabilis in hospitalized patients from 1 January 2012 to 31 December 2015 were studied retrospectively. Results A total of 266 strains wereisolated. The specimens mainly isolated from urine (57.89%), followed by secretion (9.02%), drainage fluids (7.89%),sputum (7.89%), pus(7.14%) and blood(3.76%). The specimens were mainly isolated from the Department of UrinarySurgery (19.92%), followed by Intensive Care Unit (12.78%) and Department of Rehabilitation (10.53%). The drug re-sistance rates of Proteus mirabilis to Furantoin, Tetracycline were >90%, to Ticarcillin/Clavulanic Acid, Ertapenemwere lowest ， both 0. The resistance rate of Proteus mirabilis to Cefazolin increased markedly, from 54.55% to 92.59%,to Ceftazidime and Cefepime decreased sharply, from 33.33%, 36.11% to 3.70% and 7.32%, respectively. ConclusionProteus mirabilis separation rate from 2012 to 2015 is in a growing trend. This trend reminds that along with the exten-sive use of antibiotics clinically, the hospital infection rate showes a trend of rising. Proteus mirabilis has different drugresistance to different antimicrobial drugs. It is essen-tial for strengthening the management of antimicrobialabuse and monitoring results of antibiotic resistance.[Key words] Proteus mirabilis; Infection; Clinical dis-tribution; Drug resistance[ 基金项目 ] 国家自然科学基金资助项目（ 81101224 ）。[ 作者简介 ] 于波心（ 1993- ），女，硕士研究生，主要从事老年病研究。[ 通讯作者 ] 王佳贺（ 1973- ），女，博士，教授，博士生导师，主要从事老年病研究。116