2003年～2007年非发酵革兰阴性杆菌的耐药性变迁  

Drug resistance evolution of non-fermentative Gram-negative bacillus from 2003 to 2007

作　　者：喻华[1,2] 刘华[1,2] 颜英俊[1,2] 周忠华[1,2] 杨永长[1,2] 黄文方[1,2] 

机构地区：[1]四川省医学科学院,610072 [2]四川省人民医院检验科

出　　处：《实验与检验医学》2008年第5期489-492,共4页Experimental and Laboratory Medicine

摘　　要：目的调查分析2003～2007年临床分离的非发酵革兰阴性杆菌的分离和对抗菌药物耐药性变迁情况。方法采用VITEK-32全自动微生物分析仪和ATB自动微生物分析仪鉴定和药敏系统对临床分离的常见非发酵革兰氏阴性杆菌2880株进行鉴定和药敏试验。结果在五年观察中,我院3种常见的非发酵革兰氏阴性杆菌前3位依次是铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌。5年中,除阿米卡星外,其余抗生素对2880株非发酵革兰氏阴性杆菌的耐药率均呈上升的趋势。尤其是铜绿假单胞菌对氨曲南、头孢匹肟、头孢哌酮/舒巴坦、亚胺培南,鲍曼不动杆菌对氨曲南耐药率上升明显,嗜麦芽窄食单胞菌对10种抗生素呈现多重耐药,除复方新诺明耐药率较低外,其余均在33.6%～100%。结论动态了解常见非发酵革兰氏阴性杆菌的分离率和对抗菌药物耐药性变迁情况,有助于临床合理选用抗生素,提高治愈率。Objective To isolate non-fermentative Gram-negative bacillus and analyze its drug resistance evolution from 2003 to 2007. Methods The characterization and drug sensitivity test of 2880 clinical isolates of non-fermentative Gram-negative bacillus were done by VITEK-32 automatic microbe system and ATB microbial analysis system. Results The first three common non-fermentative Gram-negative bacillus were successively Pseudomonas aeruginosa, A cinetobacter baumannii and Stenotrophomonas mahophilia in our hospital in the past 5 years. Except for amikacin, the resistance rates to other antibiotics of 2880 strains with non-fermentative Gram-negative bacillus showed an increasing tendency, especially Pseudomonas aeruginosa to aztreonam, cefepime, cefoperazone sulbactam and imipenem and A cinetobacter baumannii to aztreonam. Except for sulfamethoxazole compound, stenotrophomonas maltophilia showed multi-drug resistances to 10 antibiotics with resistance rates from 33.6% to 100%. Conclusion To investigate the isolation rate and drug resistance evolution of non-fermentative Gram-negative bacillus dynamically will be useful for rational medication and improvement of cure rate.

关 键 词：非发酵革兰氏阴性杆菌 抗生素 耐药性 

分 类 号：R446.5[医药卫生—诊断学] Q939.92[医药卫生—临床医学]