摘要
目的对重庆医科大学附属第二医院2001年1月1日至2009年12月31日10年临床标本中分离的主要革兰阴性杆菌耐药性变化进行分析,为临床合理用药提供依据。方法采用回顾性方法对十年间大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和不动杆菌的药敏结果用WHONET 5.4软件进行统计分析。结果大肠埃希菌、肺炎克雷伯菌对亚胺培南耐药率小于5%;对阿米卡星、哌拉西林/他唑巴坦、头孢吡肟耐药率小于30%;对三代头孢、头孢西丁和氨曲南耐药率为40%左右;对青霉素类、喹诺酮类和磺胺类耐药率大于50%。铜绿假单胞菌对头孢他啶、头孢吡肟和亚胺培南耐药率小于40%;对其余监测抗生素耐药率大于50%。不动杆菌属对亚胺培南耐药率小于25%(2009年除外),对其余监测抗生素耐药率很高,维持在50%～96%。铜绿假单胞菌、鲍曼不动杆菌泛耐药菌检出率分别为0～14%和0～48%。结论革兰阴性杆菌对常用抗菌药物的耐药已非常普遍,且有逐年升高的趋势;肠杆菌科对碳青霉烯类、阿米卡星、哌拉西林/他唑巴坦、头孢吡肟耐药率相对较低;非发酵菌耐药性增加明显,铜绿假单胞菌、不动杆菌泛耐菌增加明显;严格控制抗菌药物的应用及耐药菌和泛耐药菌的传播和爆发流行已迫在眉睫。
Objective To study the drug-resistance diversity of main Gram-negative bacilli isolated from inpatients from 2001.1.1 to 2009.12.31 and provide information for rational use of drugs.Methods The antimicrobial sensitivity test results of Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Acinetobacter from 2001.1.1 to 2009.12.31 were analysed by WHONET 5.4 software.Results The resistance rates of Escherichia coli and Klebsiella pneumoniae to Imipenem were less than 5%,to Amikacin,Piperacillin/Tazobactam and Cefepime less than 30%,to the third generation Cephalosporins,Cefoxitin and Aztreonam less than 40%,and to Penicillins,Quinolones and SMZ more than 50%.The resistance rates of Pseudomonas aeruginosa to Ceftazidime,Cefepime and Imipenem were less than 40%,while to the other monitored antibiotics more than 50%.The resistance rate of Acinetobacter to Imipenem was less than 25%（except in 2009）,and to the other monitored antibiotics was 50% to 96%.The pan-resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii were 0 to 14% and 0 to 48% respectively.Conclusion Gram-negative bacilli are generally resistant to commonly used antimicrobial agents with an increasing trend;The resistance rates of Enterobacteriaceae to Carbapenem,Amikacin,Piperacillin/Tazobactam and Cefepime are relatively low.The resistance of nonfermenters has increased obviously,and the pan-resistance of Pseudomonas aeruginosa and Acinetobacter have significantly increased.Strict control on the use of antimicrobial drugs and the spread and breakout of resistant and pan-resistant strains becomes imminent.
出处
《中国微生态学杂志》
CAS
CSCD
2013年第2期179-183,共5页
Chinese Journal of Microecology
