摘要
目的调查及讨论昆明地区1999年～2003年5年间革兰阴性菌(GNB),特别是肠杆菌科细菌的耐药变迁,为合理使用抗生素提供依据.方法利用WHONET5统计分析1999年～2003年从昆明市四家医院提供的共13 807株GNB耐药监测数据,分析和讨论前10位共12 671株细菌特别是肠杆菌科的耐药变迁.结果近5年细菌检出率为:大肠埃希菌(27%)、铜绿假单胞菌(14%)、克雷伯菌(10%)、不动杆菌(8%)、伤寒沙门氏菌属(8%)等.5年间除哌拉西林/他唑巴坦外,其余测试的8种抗生素药物敏感率均下降,其中亚胺培南、头孢哌酮/他唑巴坦、头孢他啶等敏感性下降10%～20%.亚胺培南仍对肠杆菌科保持非常高的敏感性(96%～100%).头孢哌酮/舒巴坦总敏感率虽高(84%),但2003年明显降低(69%),头孢他啶敏感率从1999年的75%降至55%;头孢吡肟药敏也有类似的下降趋势,环丙沙星、庆大霉素、氨苄青霉素耐药率明显增加.结论昆明地区GNB耐药情况日趋严重.亚胺培南对肠杆菌科保持非常高的敏感性;头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星仍保持较高的敏感性;环丙沙星、庆大霉素、氨苄青霉素耐药增加明显.
Objective To survey and analyze the changes of antibiotic resistance of Gram-negative bacteria,especially Enterobacteriaceae,in Kunming city from 1999 to 2003.Methods The data from 1999 to 2003 were provided by 4 hospitals in Kunming city and the resistances to antibiotics of 12 671 strains of Gram-negative bacteria were analyzed retrospectively.Results The most common bacteria were Escherichia coli (27%),Pseudomonas aeruginosa (14%),Klebsiella (10%),Acinetobacter (8%),and Salmonella typhi (8%).Except to piperacillin/tazobactam,bacterial susceptibility to other eight antibiotic was declined during the five years.The sensitivity rate to imipenem,cefoperazone/tazobactam,and ceftazidime declined 10% to 20%.Although the incidence of imipenem-resistant pseudomonas maltophilla increaes,imipenem still kept very high sensitivity rate (96%～100%) to colibacilli.The overall sensitivity rates of cefoperazone/sulbactam were high (84%) which was lowest in 2003 (69%).The sensitivity rate of ceftazidime declined year by year (from 75% to 55%).The similar tendency was observed in cefepime,ciproflozacin,gentamicin and ampicillin.Conclusions Our observation revealed quikly growing resistance of Gram-negative bacteria in Kunming city.While Imipenem remiains fairly high sensitive to colibacilli,cefoperazone/sulbactam,paperacillin/ tazobactam,and amikacin exhbit relative high but gradual declined sensitivity.Because of high resistance ciprofloxacin,gentamicin and ampicillin are not rational choices in infection induecd by Escherichia coli.
出处
《中国呼吸与危重监护杂志》
CAS
2005年第4期298-302,共5页
Chinese Journal of Respiratory and Critical Care Medicine
