耐碳青霉烯类肠杆菌科细菌体外抗菌活性分析  

In vitro activity of antimicrobial agents against carbapenem-resistant Enterobacteriaceae

作　　者：宋国蓉 吴晓燕 冯雪君 

机构地区：[1]嘉兴市第二医院,浙江嘉兴314000

出　　处：《中国微生态学杂志》2016年第5期524-527,共4页Chinese Journal of Microecology

基　　金：嘉兴市重点科技创新团队基金项目(2010R50019)

摘　　要：目的了解临床分离的59株碳青霉烯酶类抗生素耐药的肠杆菌科细菌(CRE)体外药敏情况。方法采用法国生物梅里埃公司VITEK-2Compact全自动细菌分析鉴定系统进行细菌鉴定及药敏,MALDI-TOF MS确认。琼脂稀释法测定临床常用抗生素的最低抑菌浓度。结果分离的菌株以肺炎克雷伯菌为主。59株CRE除对亚胺培南和美罗培南耐药率100.0%外,对哌拉西林/他巴唑坦和阿莫西林/克拉维酸同样完全耐药。头孢他啶、头孢噻肟、氨曲南耐药率分别为91.5%、98.5%和94.8%。阿米卡星有较好的抗菌活性,耐药率为44.8%。替加环素耐药率最低,为22.0%。结论 CRE耐药率较高,头孢类、青霉素类及其复合制剂单独用药不适合作为本地区CRE菌株抗菌药物,需联合用药。替加环素目前可作为CRE理想用药,阿米卡星也可作为次选。Objective To evaluate in vitro activity of antimicrobial agents against carbapenem-resistant Enterobacteriaceae（CRE）.Methods VITEK-2Compact system was used to identify and test the sensitivity of CRE to antibiotics.All the strains were confirmed by MALDI-TOF MS.Agar dilution method was used to test minimal inhibitory concentration.Results Among all the CRE strains detected,Klebsiella pneumoniae was predominant.The drug resistance rates to Imipenem,Meropenem,Piperacillin-tazobactam and Amoxicillin-clavulanate were all 100.0%;The resistance rates to Ceftazidime,Cefotaxime and Aztreonam were91.5%,98.5% and 94.8% respectively.The drug resistance rate to Amikacin was 44.8% and to Tigecycline was the lowest（22.0%）.Conclusion The drug resistance rate of CRE is high.Cephalosporins,penicillins and their compound preparations alone are not appropriate options but combination treatments for CRE strains in this region.Tigecycline can be an ideal option,and Amikacin can be an alternative.

关 键 词：肠杆菌科细菌 碳青霉烯类 琼脂稀释法 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]