【摘要】 目的了解革兰阴性(G-)杆菌对抗菌药物的耐药性及耐药特点,指导临床合理用药。方法对2004年1-6月从临床各种标本分离的327株G-杆菌用VITEK-2全自动微生物分析仪进行鉴定及最低抑菌浓度(MIC)测定,应用WHO NET 5.1软件对数据进行统计分析。结果327株G-杆菌分类依次为大肠埃希菌(42.8%)、铜绿假单胞菌(16.8%)、克雷伯菌属(12.8%)、不动杆菌属(8.0%)和肠杆菌属(6.7%)。检出产超广谱β-内酰胺酶(ESBLs)菌71株(21.7%),其中大肠埃希菌59株,克雷伯菌属12株;产ESBLs菌对哌拉西林/他唑巴坦的耐药率(1.5%)明显低于哌拉西林(89.7%)。327株菌对复方磺胺甲唑和氨苄西林的耐药率最高,分别为94.7%和80.9%;对亚胺培南耐药率最低,为8%。呼吸道标本分离菌以铜绿假单胞菌(37株)为主,除对阿米卡星的耐药率稍低(8.1%)外,对其他绝大多数抗菌药耐药率均>40%。结论检出的G-杆菌对常用抗菌药物均呈多重耐药。在治疗产ESBLs菌引起的感染时应首选复方β-内酰胺类抗菌药及亚胺培南,慎用三代头孢菌素类抗菌药。更多还原

【Abstract】 Objective To evaluate the drug resistance of gram-negative bacilli and provide reference for the rational use of antimicrobial agents in clinic.Methods Three hundred and twenty-seven gram-negative bacilli isolated from different clinical samples from January to June in 2004 were identified and the drug sensitive tests were also detected.Results The isolated gram-negative bacilli were Escherichia coli((42.8%)),Pseudomonas aeruginosa((16.8%)),Klebsiella spp.((12.8%)),Acinetobacter spp((8.0%)),Enterobacter spp((6.7%)).71 strains((21.7%)) were ESBLs positive strains,59 of which were Escherichia coli,12 were Klebsiella spp;The resistant rate to piperacillin/tazobactam((1.5%)) is obviously lower than that to piperacillin((89.7%)).All strains had the highest resistant rate to SMZco and ampicillin,which was(94.7%) and(80.9%) respectively,and had the lowest resistant rate to imipenem(8%).The main bacteria isolated from respiratory tract was Pseudomonas aeruginosa(37 strains),except the lower resistant rate to amikacin((8.1%)),the resistant rates to most antimicrobial agents were >40%.Conclusion The isolated gram-negative bacilli had multiply resistance to antimicrobial agents.In the treatment of infection with ESBL-producing strains,compound β-lactamase antimicrobial agents and imipenem should be chosen,third generation cephalosporins should be prudent.更多还原