【摘要】 目的了解环丙沙星对革兰阴性杆菌的耐药性变迁,指导临床合理用药。方法2002—2005年每年度一定时间段内连续收集150～200株病房内分离的不重复革兰阴性杆菌,采用E试验测定细菌对11种抗菌药物的最低抑菌浓度(MIC),用WHONET5.4软件进行统计分析。结果4年来共收集665株革兰阴性杆菌,主要菌种依次为鲍曼不动杆菌142株(21.35%)、大肠埃希菌134株(20.15%)、肺炎克雷伯菌128株(19.25%)、铜绿假单胞菌111株(16.69%)、嗜麦芽窄食单胞菌42株(6.32%)、阴沟肠杆菌41株(6.17%)。所测的抗菌药物敏感性均呈下降趋势,亚胺培南敏感率最高(75%),其次为阿米卡星(72%)。环丙沙星敏感率从2002年的62%下降至41%,其中鲍曼不动杆菌的耐药性增加非常显著,从2002年的25%上升至2005年的75%,大肠埃希菌的耐药率均维持在较高水平(75%～86%),肺炎克雷伯菌、铜绿假单胞菌至2005年仍分别有58%和69%的菌株敏感,阴沟肠杆菌的耐药率也较高(平均为46%),嗜麦芽窄食单胞菌的耐药率平均为17%,但有24%的菌株为中介。结论环丙沙星对革兰阴性杆菌敏感性呈下降趋势,对不同的菌种抗菌活性有较大差异,应结合药物敏感试验结果合理使用药物。更多还原

【Abstract】 Objective To know the changes of tolerance of Gram-negative bacilli to ciprofloxacin and to give direction to clinic drug use.Methods 150-200 non-repeated Gram-negative bacilli were collected for some time period in each year from 2002 to 2005,and E-test was applied on determining MIC of 11 antibacterial drugs on Gram-negative bacilli.The data analysis was used with WHONET 5.4 software.Results 665 Gram-negative bacilli were collected after 4 years,the main bacteria was Acinetobacter baumannii(21.35%),then Escherichia coli(20.15%),Klebsiella pneumonia(19.25%),Pseudomonas aeruginosa(16.69%),Stenotrophomonas maltophilia(6.32%),Enterobacter cloacae(6.17%).The susceptibility of ciprofloxacin descended from 62%in 2002 to 41%in 2005,and the tolerance of Acinetobacter baumannii to ciprofloxacin increased remarkably,ascended from 25%to 75%since 2002,Escherichia coli’s maintained the high level of 75%-86%and Klebsiella pneumonia,Pseudomonas aeruginosa,Enterobacter cloacae’s rose to 42%,31%,46%respectively.Conclusion The susceptibility of ciprofloxacn to Gram-negative bacilli is declined yearly and the antibiotic activity of ciprofloxacn is different on various bacteria.It is suggested that the doctor should use antibiotics according to the drug susceptibility test for decreasing the drug resistance.更多还原