【摘要】 目的调查近5年重症监护病房(ICU)革兰阴性杆菌分离率及对常用抗菌药物的耐药性变化趋势,以指导临床合理使用抗菌药物。方法分析2003年1月-2007年12月ICU分离出的革兰阴性杆菌,采用纸片扩散法进行药敏检测,并用WHONET5.3软件进行数据分析。结果650株革兰阴性杆菌中占前3位的为不动杆菌属39.1%、铜绿假单胞菌20.9%及大肠埃希菌14.7%;不动杆菌属对亚胺培南、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦的耐药率最低,分别为3.7%、28.3%和42.9%;近2年铜绿假单胞菌对亚胺培南的耐药率明显升高(58.0%);除嗜麦芽寡养单胞菌外,亚胺培南对其他革兰阴性杆菌保持强大的抗菌活性,嗜麦芽寡养单胞菌对头孢他啶的耐药率仍最低19.4%;革兰阴性杆菌对头孢哌酮/舒巴坦与哌拉西林/他唑巴坦的耐药率<50.0%,对其他抗菌药物高度耐药,5年中耐药率无明显变化。结论非发酵菌在ICU革兰阴性杆菌中占有较高比例,亚胺培南(除嗜麦芽寡养单胞菌外)、头孢哌酮/舒巴坦与哌拉西林/他唑巴坦对革兰阴性杆菌具有很好的敏感性,对其他抗菌药物耐药率较高。更多还原

【Abstract】 OBJECTIVE To study the bacterial resistance variation rates among Gram-negative bacilli from our hospital′s intensive care unit(ICU) during recent five years,as a guidance for rational use of antibiotics.METHODS From Jan 2003 to Dec 2007,antimicrobial susceptibility testing was performed on the Gram-negative bacilli isolated from ICU in our hospital by Kirby-Bauer method.The results were analyzed by WHONET 5.3.RESULTS The first three pathogens of 560 strains were Acinetobacter spp(39.1%),Pseudomonas aeruginosa(20.9%) and Escherichia coli(14.7%).The resistance rate of Acinetobacter spp to imipenem,cefoperazone-sulbactam and piperacillin-tazobactam were 3.7%,28.3% and 42.9%,respectively.The resistance rate of P.aeruginosa to imipenem were increasing in recent 2 years(58%),the susceptibility rate of Gram-negative bacilli to imipenem was the higest(except Stenotrophomonas maltophilia).The resistance rate of S.maltophilia to ceftazidime was the lowest(19.4%).The resistance rate of Gram-negative bacilli to cefoperazone-sulbactam and piperacillin-tazobactam was lower(<50.0%),but to other antibiotics was much higer.CONCLUSIONS In ICU,the most Gram-negative bacilli are non-fermentative,imipenem(except S.maltophilia),cefoperazone-sulbactam and piperacillin-tazobactam remain highly active against Gram-negative bacilli,the activities of other antibiotics are lower.更多还原