革兰阴性杆菌对亚胺培南耐药率的变迁  

Vicissitudes of Resistance to Imipenem in Gram-negative Bacilli

作　　者：郭普[1,2] 乔艳[3] 赵峰[4] 李峰[2] 郑晶[2] 沈继龙[1] 

机构地区：[1]安徽医科大学病原生物学教研室,230032 [2]安徽省蚌埠医学院第一附属医院检验科,233004 [3]安徽省蚌埠医学院第一附属医院感染病科,233004 [4]安徽省蚌埠医学院第一附属医院肿瘤外科一病区,233004

出　　处：《中华全科医学》2010年第5期641-642,共2页Chinese Journal of General Practice

摘　　要：目的调查革兰阴性杆菌对亚胺培南的耐药率变迁。方法收集2007年1月-2009年12月从蚌医附院患者各种临床标本中分离的革兰阴性杆菌,使用VITEK-32全自动微生物分析仪进行细菌鉴定和药敏试验,对结果进行回顾性分析。结果共分离出革兰阴性杆菌2256株,42个细菌种,肠杆菌科细菌1258株,占55.76%,非发酵菌751株,占33.29%,分离率前5位的病原菌分别是大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌和阴沟肠杆菌。肠杆菌科细菌对亚胺培南的耐药率较低,除聚团肠杆菌外,其他肠杆菌科细菌对亚胺培南的耐药率均<10.00%,肺炎克雷伯菌6.94%和大肠埃希菌4.83%。嗜麦芽窄食单胞菌、鲍曼不动杆菌、铜绿假单胞菌、洛菲不动杆菌和荧光假单胞菌对亚胺培南的耐药率分别为100.00%、66.84%、35.29%、28.00%和25.00%。结论临床分离的革兰阴性杆菌以大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌为主,亚胺培南对肠杆菌科细菌具有非常强的体外抗菌活性,对非发酵菌的体外抗菌活性较差,铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌和肺炎克雷伯菌对亚胺培南的耐药率呈上升趋势。Objective To investigate the vicissitudes of resistance to imipenem in Gram-negative bacilli isolated from clinical specimens.Methods Gram-negative bacilli were isolated from various clinical specimens in our hospital from Jan 2007 to Dec 2009.The identification and antimicrobial susceptibility test was determined by VITEK-32 full automated microbiology analyzer.The data were analyzed retrospectively.Results A total of 2 256 strains of Gram-negative bacilli were isolated including 42 species and 1 258 isolates of Enterobacteriacaeae,and 751 isolates of nonfermenters,accounted for 55.76 % and 33.29%,respectively.The most predominant pathogens were Escherichia coli,Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsierlla pneumoniae and Enterobacter cloacae,The resistant rate of Enterobacteriacaeae to imipenem was lower than 10.00% except for Enterobacter agglomerans.The resistant rates of Klebsierlla pneumoniae,Escherichia coli,Stenotrophomonas maltophiia.Acinetobacter baumannii,Pseudomonas aeruginosa,Acinetobacter lwoffii and Pseudomonas fluorescens to imipenem were 6.94%,4.83%,100.00 %,66.84%,35.29%,28.00% and 25.00%,respectively.Conclusion Escherichia coii,Acinetobacter baumannii and Pseudomonas aeruginosa were predominant pathogens.Imipenem had high antimicrobial activity to Enterobacteriacaeae,but not to nonfermenters.The resistant rates of Escherichia coii,Acinetobacter baumannii,Pseudomonas aeruginosa and Klebsierlla pneumoniae to imipenem increased gradually.

关 键 词：革兰阴性杆菌 亚胺培南 耐药率 

分 类 号：R446.51[医药卫生—诊断学] R446.54[医药卫生—临床医学]