摘要
目的 :调查我院监护病房革兰阴性杆菌耐药状况 ,了解起广谱 β -内酰胺酶 (ESBLs)菌株的发生率。 方法 :用E试验法测定 2 0 0株革兰阴性杆菌对 13种抗生素的最低抑菌浓度 (MIC)及细菌产ESBL的情况。结果 :亚胺培南对所有受试菌保持最高抗菌活性 ,细胞耐药率为 6 .5 % ;头孢哌酮 /舒巴坦、阿米卡星、头孢吡肟、哌拉西林 /他唑巴坦、头孢他定及阿莫西林 /克拉维酸耐药率 18%～ 30 %之间 ;其他抗生素耐药率在 4 4 %～ 5 1%之间。筛选出ESBLs产生菌 2 9株 ,以大肠埃希氏菌、肺炎克雷伯菌和鲍氏不动杆菌为主 ,ESBLs检出率分别为 6 6 .7%、4 7.1%和 2 5 .0 %。亚胺培南对所有大肠埃希氏菌、肺炎克雷伯菌和鲍氏不动杆菌ESBLs菌杆都敏感。新药埃托培南 (MK - 0 82 6 )对 2 0 0 1年收集的 10 0株革兰阴性杆菌有较强的抗菌活性 ,总抑菌率为 85 % ,对ESBLs产生菌的抗菌活性与亚胺培南相似。两年资料相比 ,头孢哌酮 /舒巴坦耐药率由 11%增加至2 6 % ,其他抗生素耐药率变化不大。结论 :亚胺培南抑菌率最高 ,对ESBLs产生菌有较强的抗菌活性 ,而加酶抑制剂抗生素的滥用 ,已造成细菌对其耐药率升高 ,且对付产酶耐药株感染逐渐失去优势。
Objective: To investigate the Gram-negative bacilli resistance rates in ICU and learn the situation of ESBLs-producing strains. Methods: Using the E-test to measure the minimal inhibition concentration (MIC) of 13 antibiotics against 200 strains Gram-negative bacilli. Results:The drug-resistance rates of imipenem is the lowest,which is 6.5%.Cefoperazone/sulbactam and amikacin?cefepime?piperacillin/tazobactam?ceftazidime and amoxicillin/clavulanic acid have a slightly higher resistant rates,which are among 18%～30%.The resistance rates are among 44% to 51% with other six antibiotics (except ertapenem).Compared with the survey in last year,the drug-resistance rates of cefoperazone/sulbactam increased from 11% to 26%,while the others showed fewer changes.29 ESBLs-producing strains tested by TZ/TZL showed higher susceptibility to imipenem and lower susceptibility to cefoperazone/sulbactam and ticarcillin/clavulanic acid. Conclusion: Imipenem has the highest antibacterial activity and is also effective to ESBLs-producing strains;the abuse of antibiotics with β-lactamase inhibitors leads to rise in drug-resistance rate.
出处
《重庆医科大学学报》
CAS
CSCD
2003年第2期213-216,共4页
Journal of Chongqing Medical University
