革兰阴性杆菌对亚胺培南耐药率的变迁  

Drug resistance vicissitudes of gram-negative bacilli to imipenem

作　　者：张秀明[1] 张炽伦[1] 孙各琴[1] 王柏旺[1] 曾宗跃[1] 卢兰芬[1] 吴秀娟[1] 冯雪琴[1] 杨有业[1] 

机构地区：[1]中山大学附属中山市人民医院检验医学中心,广东中山528400

出　　处：《中华医院感染学杂志》2011年第4期766-768,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查革兰阴性杆菌对亚胺培南耐药率的变化。方法收集2007年1月-2008年12月从住院患者各种临床标本中分离的革兰阴性杆菌,采用MicroScan NC31、NC33鉴定药敏复合板进行鉴定和药敏试验,对结果进行回顾性调查。结果共分离出革兰阴性杆菌4658株,肠杆菌科细菌1709株,占36.7%;非发酵菌2949株,占63.3%;分离率前5位的病原菌依次是铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍氏不动杆菌和洋葱伯克霍尔德菌;肠杆菌科细菌对亚胺培南的耐药率非常低,均<2.0%;嗜麦芽寡养单胞菌、洋葱伯克霍尔德菌、铜绿假单胞菌和鲍氏不动杆菌对亚胺培南的耐药率分别为98.3%、62.4%、30.5%、10.1%。结论临床分离的革兰阴性杆菌以非发酵菌为主,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,铜绿假单胞菌和鲍氏不动杆菌对亚胺培南的耐药率呈较大幅度上升。OBJECTIVE To investigate the vicissitudes of antimicrobial resistance to imipenem in Gram-negative bacilli isolated from clinical specimens. METHODS Gram-negative bacilli were isolated from various clinical specimens in our hosiptal from Jan 2007 to Dec 2008. MicroScan NC31, NC33 composite board were used to identification and drug sensitive test and to analyzing all the results vial regression. RESULTS A total of 4658 strains of Gram-negative bacilli were isolated. From which 1709 isolates of Enterobacteriaceae and 2949 isolates of nonfermenters accounted for 36.7% and 63.3%, respectively. The most predominant pathogens were Pseudo- monas aeru ginosa （41.7%）, Escherichia col i （21.1%）, K lebsiella pneumoniae （11.1%）, Acinetobacter bauman- nil （10.8%）, and Burkhol deria cepacia （5.60%）. The resistance rate of Enterobaeteriaceae to imipenem was very low. All of these were below 2.0%. The rates of Stenorophomonas maltophlia, B. cepacia, P. aeruginosa and A. baumannii to imipenem were 98. 3%, 62. 4%, 30. 5% and 10. 1%, respectively. CONCLUSION Nonfermenting bacteria are the predominant Gram-negative bacilli. Imipenem has high antimicrobial activity in vitro to Enterobaeteriaceae, but has less antibacterial activity to non-fermenting bacteria. The resistance rates of P. aeruginosa and A. baumannii to imipenem increase to a great extent.

关 键 词：革兰阴性杆菌 亚胺培南 抗菌活性 

分 类 号：R978.1[医药卫生—药品]