【摘要】 目的监测2008年中国革兰阴性(G-)杆菌的耐药性。方法收集2008年9月至12月国内10家教学医院收集的1057株非重复的G-杆菌。菌株经中心实验室复核后,采用琼脂稀释法测定美罗培南等广谱抗菌药物的最低抑菌浓度。结果10种抗菌药物对于715株肠杆菌科细菌的抗菌活性,敏感性排在前3位的依次为美罗培南(敏感性99.4%)、亚胺培南(敏感性99.3%)、阿米卡星(90.4%)。对于大肠埃希菌和肺炎克雷伯菌,抗菌活性最高的是:美罗培南、亚胺培南(97.9%～100%)、哌拉西林/三唑巴坦(87.2%～97.9%)、阿米卡星(82.3%～92.9%)。对于阴沟肠杆菌、产气肠杆菌、弗劳地枸橼酸菌,活性最高的依次为美罗培南、亚胺培南(97.4%～100%)、阿米卡星(87.2%～91.9%)、头孢吡肟(82.4%～93.5%)。对于铜绿假单胞菌,活性最高的药物为阿米卡星(77.4%)、美罗培南(76%)、哌拉西林/三唑巴坦(70.5%)和亚胺培南(70.5%)。鲍曼不动杆菌对于亚胺培南、美罗培南、头孢哌酮/舒巴坦的敏感性最高,分别为58.6%、57%、49.2%。对于洋葱伯克霍尔德菌,抗菌活性较高的是头孢他啶(77.4%)、美罗培南(75.5%)、哌拉西林/三唑巴坦(69.8%)。结论碳青霉烯类对肠杆菌科仍保持高活性,但鲍曼不动杆菌和铜绿假单胞菌的耐药性增加,尤其是鲍曼不动杆菌对碳青霉烯类的耐药性显著增加,值得关注。更多还原

【Abstract】 Objective To investigate antimicrobial resistance situation of nosocomial gram-negative bacilli in China in 2008.Methods A total of 1,057 consecutive and non-repetitive gram-negative bacilli strains were isolated from 10 hospitals during September,2008 to December,2008 in China.All isolates were sent to the central laboratory for reidentification and susceptibility tests.The minimal inhibitory concentration(MICs)of meropenem and other antibacterial agents were determined by agar dilution method.Results The activity of antibacterial agents against Enterobacteriaceae was in the following order:meropenem(susceptible rate,99.4%)>imipenem(99.3%)>amikacin(90.4%).The most potent agents against E.coli and K.pneumoniae included meropenem,imipenem(97.9%～100%),piperacillin/tazobactam(87.2%～97.9%),and amikacin(82.3%～92.9%).The most potent agents against E.cloacae,E.aerogenes,and Citrobacter freundii included meropenem,imipenem(97.4%~100%),amikacin(87.2%~91.9%),and cefepime(82.4%~93.5%).The most potent agents against Pseudomonas aeruginosa were amikacin(77.4%),followed by meropenem (76%),piperacillin/tazobactam(70.5%),and imipenem(70.5%).The most potent agents against Acinetobacter baumannii were imipenem(58.6%),meropenem(57%),and cefoperazone/sulbactam(49.2%).The most potent agents against Burkholderia cepacia were ceftazidime(77.4%),meropenme(75.5%),and piperacillin/tazobactam(69.8%).Conclusion Carbapenems remains very potent against Enterobacteriaceae.A.baumanni and P.aeruginosa,especially A.baumanni,have increased resistance to carbapenems.更多还原