北京地区临床分离菌对氨基糖苷类抗生素耐药情况调查研究及其耐药机理分析  

Studies on the resistance of clinical isolates and the resistant mechanism in Beijing region

作　　者：张永龙[1] 李家泰[1] 

机构地区：[1]北京医科大学第一临床医院临床药理研究所

出　　处：《中国抗生素杂志》1998年第5期371-37,共1页Chinese Journal of Antibiotics

摘　　要：研究了１９９５～１９９７年９８１株临床分离菌对氨基糖苷类抗生素的耐药性，并对其耐药机理进行分析。结果表明：９８１株临床分离菌对卡那霉素的耐药率最高，其耐药率为３６．８％，其次为新霉素，其耐药率为３１．６％，再次为庆大霉素，其耐药率为２５．３％。对阿米卡星的耐药率最低，其耐药率为５．５％。并且耐药率有逐年增加的趋势。耐药机理分析表明：大肠埃希氏菌、摩根氏菌、志贺氏菌、沙门氏菌、沙雷氏菌以产ＡＡＣ（３）－Ⅱ酶为主，柠檬酸杆菌、肺炎克雷伯氏菌、肠杆菌属、不动杆菌以通透性降低为主，１９９５年、１９９６年的临床分离菌以单纯的通透性降低为主，１９９７年则为通透性降低加细菌产ＡＡＣ（３）－Ⅱ酶。葡萄球菌主要产ＡＰＨ（２＂）＋ＡＡＣ（６′）＋ＡＮＴ（４′）－Ⅰ酶与ＡＰＨ（２＂）＋ＡＡＣ（６′）酶，并且１９９５～１９９７年产酶率逐年增高。The resistant rates of 981 strains clinical isolates from 1995 to 1997 to amino glycoside antibiotics were measured and the resistant mechanisms were studied. Results showed that the resistant rate of kanamycin was the highest, which was 36.8%; followed by neomycin, which was 31.5%; and gentamicin was the third, it was 25.5%. The resistant rate of amikacin was the lowest. Moreover, the resistant rates increased gradually from 1995 to 1997. The analysis of resistant mechanism indicated AAC(3) Ⅱ were mostly produced by E.coli, Morganella spp, Shigella, Salmonella spp, and Serratia spp. However, Citrobacter spp, K.pneumoniae, Enterobacter and Acinetobacter emergened resistance by decreasing permeability. Because of the producing of APH(2")+AAC(6′)+ANT(4′) Ⅰ enzyme, Staphylococcus spp were resistant to aminoglycosides, but the resistance of P.aeruginosa was attributed to the decreasing permeability in combining with enzyme.

关 键 词：氨基糖苷类 抗生素 耐药率 耐药性 

分 类 号：R978.12[医药卫生—药品]