关键词: 耐药基因, 多重耐药菌, 广泛耐药菌, 革兰阴性杆菌, 医院感染, 老年

Abstract: To guide the reasonable antibiotic clinical use and provide the reference for effective prevention and nosocomial infection control by understanding the drug resistance and distribution in elder patients infected with multi-drug resistant and extensively-drug resistant Gram negative bacillus in Huadong Hospital. The data of 228 elder patients infected with multi-drug resistant bacillus and 42 patients infected with extensively-drug resistant bacillus were studied retrospectively(all the elder patients were over 60 years old). Bacterial culture, identification and drug susceptibility were performed for the specimens from patients(sputum, blood, urine, bile, wounds secretion and so on). The resistant genes of 8 extensively-drug resistant Acinetobacter baumannii were determined by polymerase chain reaction(PCR). The rank of the multi-drug resistant bacillus was Acinetobacter baumannii, Pseudomonas aeruginosa and Escherichia coli, as well as the rank of the extensively-drug resistant bacillus was Acinetobacter baumannii, Pseudomonas aeruginosa and Burkholderia cepacia. The TEM, SHV, PER, ant(2″)-Ⅰ, ant(3″)-Ⅰ, ant(6')-Ⅰb, OXA-23, gyrA and qacEΔ1 genes were detected in the extensively-drug resistant Acinetobacter baumannii. The results of IMP, VIM and OXA-24 genes were negative. Since the severe drug resistance of Acinetobacter baumannii and Pseudomonas aeruginosa from elder patients in Huadong Hospital, especially in the department of respiration and intensive care unit, we should effectively prevent, delay and control the generation and spreading of resistant isolates by strengthening the reasonable antibiotic use as well as monitoring the resistant isolates.

Key words: Drug resistant gene, Multi-drug resistant bacterium, Extensively-drug resistant bacterium, Gram negative bacillus, Nosocomial infection, Elder