耐碳青霉烯类药物的细菌种类分布及耐药特性分析  

Analyze characteristics of species and drug resistance to Carbapenem resistant bacteria

作　　者：杨秋燕[1] 邱烨[1] 

机构地区：[1]福建中医药大学附属第二人民医院检验科,福州350001

出　　处：《检验医学与临床》2015年第4期486-488,共3页Laboratory Medicine and Clinic

摘　　要：目的探讨三甲中医医院耐碳青霉烯类药物的细菌的种类分布及耐药性情况。方法回顾性分析从临床分类筛选出的74株耐碳青霉烯类药物的抗菌药物的细菌,着重分析其分布种类及耐药特点。结果脑病病区耐碳青霉烯类药物的细菌检出率最高,耐药细菌种类以铜绿假单胞菌为主。30株铜绿假单胞菌对10种抗菌药物的耐药率较低的为妥布霉素(20.0%)、阿米卡星(13.3%);26株耐碳青霉烯鲍曼不动杆菌均为泛耐药株,耐药率较低的为米诺环素(69.2%)、头孢哌酮/舒巴坦(55.6%);18株耐碳青霉烯肠杆菌科细菌均为泛耐药株,耐药率较低的为米诺环素(44.4%)、四环素(55.6%)。结论耐碳青霉烯铜绿假单胞菌对氨基糖苷类抗菌药物较为敏感,但临床使用时要注意观察耐药性的变化;耐碳青霉烯鲍曼不动杆菌治疗建议临床上采用头孢哌酮/舒巴坦与米诺环素联合用药;对碳青霉烯类耐药的肠杆菌科细菌体外对四环素类药物有效,然而其体内效果如何还有待进一步证实。耐碳青霉烯类药物的细菌的发生率越来越高,各医院应结合药敏结果,合理用药,以减轻菌株耐药性的发生速度。Objective To discuss the species and drug-resistance of carbapenem-resistance bacteria in Affiliated Second People′s Hospital of Fujian University of Traditional Chinese Medicine.Methods A total of 74 strains of carbapenem-resistance bacteria were analyzed retrospectively for the characteristics of species and drug resistance.Results The highest detection rate was in encephalopathy ward and the main drug-resistant bacteria was Pseudomonas aeruginosa.The lower drug-resistance of 30 strains Pseudomonas aeruginosa to ten kinds of antimicrobial were Tobramycin（20.0%）,Amikacin（13.3%）.The 26 strains carbapenem-resistance Acinetobacter baumannii were all pan resistant bacteria,the lower drug-resistance of these bacteria to antibacterial gents were Minocycline（69.2%）,Cefoperazone/Shu ba temple（55.6%）.The 18 strains of carbapenem-resistance Enterobacteriaceae bacteria were all pan resistant bacteria,the lower drug resistance of these bacteria were Minocycline（44.4%）,Tetracycline（55.6%）.Conclusion Carbapenem-resistance Pseudomonas aeruginosa is sensitive to aminoglycoside antibiotic-drugs,but it needs to pay attention to the changes of drug resistance in clinic.Carbapenem-resistance Acinetobacter baumannii should be treated by Cefoperazone/Shu ba temple and Minocycline in clinic.Carbapenem-resistance Enterobacteriaceae bacteria might treated effectively by tetracycline drug in vitro,but in vivo it remains to be further confirmed.

关 键 词：碳青霉烯类抗菌药物 耐药性 种类 

分 类 号：R978.1[医药卫生—药品]