肠杆菌科细菌对3种碳青霉烯类药物的耐药性分析  

Drug resistance of enterobacteriaceae isolates to three carbapenem antibiotics

作　　者：杨央 吕火祥[2] 胡庆丰[2] 王群 沈蓓琼[2] 徐娟[2] 朱永泽[2] 

机构地区：[1]浙江省宁海县妇幼保健院检验科,浙江宁海县315600 [2]浙江省人民医院检验中心,浙江杭州310014 [3]浙江省淳安县中医院检验科,浙江淳安县311700

出　　处：《中华医院感染学杂志》2011年第11期2334-2336,共3页Chinese Journal of Nosocomiology

摘　　要：目的研究3种碳青霉烯类抗菌药物对临床常见肠杆菌科细菌的体外抗菌活性,为碳青霉烯类抗菌药物用于治疗肠杆菌科细菌引起的临床感染提供依据。方法采用VITEK-32型全自动微生物分析系统进行菌株鉴定和药敏试验;对临床分离并鉴定的400株肠杆菌科细菌采用纸片扩散法(K-B法)进行厄他培南的药敏试验,用WHONET5.3软件对细菌耐药率进行统计分析。结果大肠埃希菌、肺炎克雷伯菌、奇异变形菌、阴沟肠杆菌、产气肠杆菌、褪色沙雷菌对厄他培南的敏感率分别为96.0%、60.0%、92.0%、95.0%、93.0%、93.0%;对亚胺培南敏感率分别为92.0%、74.0%、92.0%、97.5%、86.7%、100.0%;美罗培南分别为96.0%、78.0%、96.0%、95.0%、70.0%、93.3%。结论碳青霉烯类抗菌药物对肠杆菌科细菌有很好的治疗作用;但某些菌株已有较高的耐药性发生,临床应重视对碳青霉烯类耐药菌株的检测,以减缓耐药性的快速增长。OBJECTIVE To investigate in vitro antibacterial activity of three carbopenem antibiotics to clinical isolates of Enterobacteriaceae and provide bases for treatment of clinical infections caused by Enterobacteriaceae strains with carbopenem antibiotics.METHODS Strains were identified and antibiotic susceptibility were determined with VITEK32 automatic bacteria identification system.Disk diffusion tests（Kirby-Bauer tests） were performed to detect the susceptibility of ertapenem against 400 clinical isolates of Enterobacteriaceae.Antibiotic resistance rate was analysed by using WHONET 5.3.RESULTS The sensitivity rates of 150 isolates of Escherichia coli,100 isolates of Klebsiella pneumoniae,50 isolates of Proteus mirabilis,40 isolates of Enterobacter cloacae,30 isolates of Enterobacter aerogenes and 30 isolates of Serratia marcescens to ertapenem were 96.0%,60.0%,92.0%,95.0%,93.0% and 93.0% respectively.The sensitivity rates of these isolates to imipenem were 92.0%,74.0%,92.0%,97.5%,86.7% and 100.0% respectively.As to meropenem,the the sensitivity rates were 96.0%,78.0%,96.0%,95.0%,70.0% and 93.3% respectively.CONCLUSIONS Carbapenem antibiotics are effective in the treatment of infections caused by Enterobacteriaceae strains.However,relative high resistance rates have been detected in some isolates and more attention should be paid to the detection of carbapenem-resistant strains to slow down the rapid increase of antibiotic resistance.

关 键 词：肠杆菌科 碳青霉烯类 抗菌药物 厄他培南 亚胺培南 美罗培南 

分 类 号：R378[医药卫生—病原生物学]