临床常见分离菌对不同配比头孢哌酮/舒巴坦的药敏差异  

Difference in antimicrobial susceptibility of common clinical pathogens to different ratios of cefoperazone/sulbactam antimicrobial disks

作　　者：赵越[1] 张莉滟[1] 陈莲[2] 叶倩君[3] 

机构地区：[1]广东省医学科学院广东省人民医院,广东广州510080 [2]广州中医药大学附属骨伤科医院,广东广州510240 [3]广州医科大学金域检验学院,广东广州510182

出　　处：《中国感染控制杂志》2016年第10期744-747,共4页Chinese Journal of Infection Control

摘　　要：目的了解临床常见病原菌对不同配比头孢哌酮/舒巴坦药敏纸片的耐药性,为临床合理选择头孢哌酮/舒巴坦提供依据。方法收集某院2014年上半年临床分离病原菌1 141株,采用纸片扩散法检测不同病原菌对头孢哌酮/舒巴坦两种药敏纸片(70/35μg与75/75μg)的抗菌活性。结果 1 141株病原菌中肠杆菌科细菌675株(59.16%),非发酵菌447株(39.18%),其他革兰阴性杆菌19株(1.66%)。对头孢哌酮/舒巴坦两种药敏纸片(70/35μg、75/75μg)的耐药率:超广谱β-内酰胺酶(ESBLs)阳性大肠埃希菌(eco,221株)分别为7.69%、2.26%,肺炎克雷伯菌(kpn,92株)分别为10.87%、3.26%;亚胺培南耐药鲍曼不动杆菌(IRAB 295株)分别为54.92%、11.19%;两种药敏纸片抗菌活性比较,差异均有统计学意义(P<0.05)。ESBLs阴性肠杆菌科细菌(eco,135株;kpn,98株)、亚胺培南敏感鲍曼不动杆菌(51株)、铜绿假单胞菌(48株)、嗜麦芽窄食单胞菌(22株)对两种头孢哌酮/舒巴坦药敏纸片的耐药率比较,差异均无统计学意义(均P>0.05)。结论 ESBLs阳性肠杆菌科细菌与IRAB对不同配比头孢哌酮/舒巴坦药敏纸片的抗菌活性具有差异,临床治疗此类细菌引起的感染时要充分考虑头孢哌酮/舒巴坦的剂型,以达到预期治疗效果。Objective To understand the antimicrobial resistance of common clinical pathogens to antimicrobial disks containing different ratios of cefoperazone/sulbactam,so as to provide basis for rational application of cefoper-azone/sulbactam in clinic.Methods 1 141 pathogens isolated from clinical specimens in a hospital in the first half year of 2014 were collected,disk diffusion method was adopted to detect antimicrobial activity of two kinds of cef-operazone/sulbactam disks （70/35 μg and 75/75 μg）.Results Of 1 141 pathogenic strains,675 （59.16%）were En-terobacteriaceae,447 （39.18%）were non-fermentative bacteria,and 19 （1 .66%）were other gram-negative bacilli. Resistance rates of pathogens to 70/35μg and 75/75 μg cefoperazone/sulbactam antimicrobial disks were as follows：extended-spectrumβ-lactamases（ESBLs）-producing Escherichia coli （n=221）were 7.69% and 2.26% respective-ly,ESBLs-producing Klebsiella pneumoniae （n=92）10.87% and 3.26% respectively,imipenem-resistant Acineto-bacter baumannii （IRAB,n=295）54.92% and 11 .19%respectively;there were significant differences in antimicrobial activity between two ratios of antimicrobial disks（P 〈0.05）.While antimicrobial resistance rates of ESBLs-negative＆nbsp;Enterobacteriaceae （Escherichia coli ,n = 135;Klebsiella pneumoniae ,n =98）,imipenem-sensitive Acinetobacter baumannii （ISAB,n=51）,Pseudomonas aeruginosa （n=48 ）,and Stenotrophomonas maltophilia （n=22）were not significantly different （all P 〉0.05）.Conclusion Antimicrobial activity of two different ratios of cefoperazone/sulbactam antimicrobial disks to ESBLs-producing Enterobacteriaceae and IRAB is different,attention should be paid to ratios of cefoperazone/sulbactam during the treatment ,so as to achieve the desired therapeutic effect.

关 键 词：头孢哌酮/舒巴坦 超广谱β-内酰胺酶 ESBLS 肠杆菌科细菌 亚胺培南耐药鲍曼不动杆菌 纸片扩散法 耐药性 抗药性 微生物 合理用药 

分 类 号：R181.32[医药卫生—流行病学]