2010-2015年郑州大学第一附属医院亚胺培南对革兰阴性杆菌的耐药性分析  

Analysis of the drug resistance of gram-negative bacteriaagainst imipenem at the First Affiliated Hospital of Zhengzhou University between 2010 and 2015

作　　者：苟建军[1] 任益慧 郭小兵[1] 胡晓欣[1] 贺小红[1] 田富云[1] 

机构地区：[1]郑州大学第一附属医院检验科,河南郑州450052

出　　处：《现代预防医学》2017年第4期760-763,共4页Modern Preventive Medicine

基　　金：河南省医学科技攻关计划项目(201403044)

摘　　要：目的了解亚胺培南对革兰阴性杆菌的抗菌活性变化,为临床合理用药提供依据。方法收集2010-2015年间郑州大学第一附属医院临床分离的革兰阴性杆菌,进行鉴定及药敏试验。结果 2010-2015年共检出革兰阴性菌56 975株,其中,肠杆菌科细菌27 245株(47.82%),非发酵菌25 793株(45.27%),检出率居于前四位依次为大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌和肺炎克雷伯菌;6年间,产超广谱β-内酰胺酶(Extended spectrumβ-lactamases,ESBLs)肠杆菌科细菌、耐碳青霉烯类肠杆菌科细菌、多重耐药铜绿假单胞菌及鲍曼不动杆菌的检出率均呈上升趋势。大肠埃希菌对亚胺培南的耐药率由0.12%上升至2.44%,肺炎克雷伯菌由0.29%上升至22.72%,鲍曼不动杆菌由43.46%上升至83.19%,铜绿假单胞菌对亚胺培南的耐药率2010-2014年由20.83%上升至31.50%,2015年下降至23.91%。结论亚胺培南对肠杆菌科细菌的抗菌活性较强,但肺炎克雷伯菌的耐药率增幅明显;对非发酵菌的抗菌活性较差,尤以鲍曼不动杆菌显著,且多重耐药菌日益增多,应引起关注。Objective The study was conducted to assess the changes in antibacterial activities of gram-negative baeteriaagainst imipenem, so as to provide a reference for rational clinical use of imipenem. Methods Gram-negative bacteria in specimens clinically isolated at the First Affiliated Hospital of Zhengzhou University were collected for bacterial identification and susceptibility test. Results A total of 56975 strains of gram-negative bacteria were isolated between 2010 and 2015, including 27245 strains of Enterobacteriaceae （47.82%） and 25793 strains of non-fermentative bacteria （45.27%）. The top four most dominant pathogens were Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae. During the six years, the positive rates of extended spectrumβ-laetamases （ESBLs）-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaeeae, multi-drug resistant P. aeruginosa, and A. baumannii were have been rising. The resistance rate of E. coli against imipenem rose from 0.12% to 2.44%, the resistance rate of K. pneumoniae rose from 0.29% to 22.72%, the resistance rate ofA. baumannii rose from 43.46% to 83.19%, and the resistance rate of P. aeruginosa against imipenem rose from 20.83% to 31.50% between 2010 and 2014, followed by a decrease to 23.91% in 2015.Conclusion Imipenem has high antibacterial activity against Enterobacteriaceae, but the resistance rate of K. pneurnoniae to imipenem has increased significantly. Meanwhile, imipenem has poor antibacterial activity against non- fermentative bacteria, especially against A. baumannii; and multi-drug resistant strains have increased, suggesting that the issue should be emphasized.

关 键 词：亚胺培南 革兰阴性杆菌 抗菌活性 多重耐药 

分 类 号：R378[医药卫生—病原生物学]