2008-2009年革兰阴性杆菌敏感性监测  

Monitoring of drug resistance of gram-negative bacilli in 2008-2009

作　　者：钟馥霞[1] 魏全珍[1] 叶国强[1] 张惠珍[1] 向开富[1] 刘丽华[1] 

机构地区：[1]深圳市宝安人民医院检验科,广东深圳518101

出　　处：《中华医院感染学杂志》2012年第8期1694-1696,共3页Chinese Journal of Nosocomiology

摘　　要：目的监测深圳地区革兰阴性杆菌的耐药情况。方法细菌鉴定及药敏试验采用MicroScan40/96全自动微生物鉴定仪,数据分析采用MicroScan Labpro2.41软件进行统计分析。结果 971株肠杆菌科细菌中,大肠埃希菌、肺炎克雷伯菌、奇异变形菌产超广谱β-内酰胺酶(ESBLs)的检出率分别为52.1%、42.7%和6.5%;未检出耐亚胺培南的肠杆菌科细菌;大肠埃希菌对测试抗菌药物敏感率较高的有阿米卡星94.0%、哌拉西林/他唑巴坦93.0%;肺炎克雷伯菌对哌拉西林/他唑巴坦和阿米卡星的敏感率分别为81.0%和80.5%;阴沟肠杆菌和产气肠杆菌对阿米卡星的敏感率在81.5%～91.0%;奇异变形菌和褪色沙雷菌对阿米卡星、头孢他啶、头孢曲松、头孢噻肟、头孢吡肟、哌拉西林/他唑巴坦和替卡西林/克拉维酸的敏感率均>85.0%;铜绿假单胞菌对亚胺培南和哌拉西林/他唑巴坦的敏感率>93.0%,对头孢他啶、哌拉西林、阿米卡星和妥布霉素的敏感率>82.5%;未检出耐亚胺培南的鲍氏不动杆菌,鲍氏不动杆菌对氨苄西林/舒巴坦、替卡西林/克拉维酸的敏感率分别80.5%和74.0%;嗜麦芽寡养单胞菌抗菌活性较高的有磺胺甲噁唑/甲氧苄啶和左氧氟沙星,敏感率分别为83.0%和78.0%,磺胺甲噁唑/甲氧苄啶的敏感率有逐年降低的趋势。结论肠杆菌科细菌、铜绿假单胞菌和鲍氏不动杆菌对亚胺培南仍有较高的抗菌活性;多药耐药的鲍氏不动杆菌不断增加,肠杆菌科细菌呈示较高的多药耐药性;产超广谱β-内酰胺酶的大肠埃希菌和肺炎克雷伯菌也逐年增加,值得关注。OBJECTIVE To monitor the drug resistance of Gram-negative bacilli in Shenzhen.METHODS MicroScan40/96 automatic microbiological identification system was used to perform bacterial identification and drug susceptibility test.MicroScan Labpro2.41 software was used for the statistical analysis.RESULTS Among 971 strains of Enterobacteriaceae,the detection rates of ESBLs produced by E.coli,K.pneumoniae and P.mirabilis were 52.1%,42.7% and 6.5%,respectively.No strain resistant to imipenem was detected.The tested antibacterial agents to which E.coli had relatively high sensitive rate were amikacin 94.0% and piperacillin/sulbactam 93.0%.The sensitive rates of K.pneumoniae to piperacillin/sulbactam and amikacin were 81.0% and 80.5%.The sensitive rates to amikacin of E.cloacae and E.aerogenes were 81.5%-91.0%.The sensitive rates to amikacin,ceftazidime,ceftriaxone,cefotaxime,cefepime,piperacillin/sulbactam and ticarcillin/clavulanic acid of P.mirabilis and S.marcescens were higher than 85.0%.The sensitive rates of P.aeruginosa to imipenem and piperacillin/sulbactam were above 93.0%,and to ceftazidime,piperacillin,amikacin and Tobramycin were over 82.5%;No imipenem-resistant Acinetobacter baumannii isolates were found.The sensitive rates of A.baumannii to ampicilli/Sulbactam and ticarcillin/clavulanic were 80.5% and 74.0%,respectively;trimethoprim/sulfamethoxazole and levofloxacin had relatively high antibacterial activity against S.maltophilia with the sensitive rates of 83.0% and 78.0%.The sensitive rate to trimethoprim/sulfamethoxazole declined year by year.CONCLUSION Imipenem remain relatively high antibacterial activity against Enterobacteriaceae,PAE and ABA;Multidrug-resistant ABA are constantly increasing,and Enterobacteriaceae present relatively high multi-drug resistance;noteworthy that ESBLs-producing E.coli and K.pneumoniae are also increasing year by year.

关 键 词：革兰阴性杆菌 抗菌药物 微生物 敏感性试验 药物监测 

分 类 号：R378[医药卫生—病原生物学]