山东省革兰阴性细菌耐药性监测

Resistance of Gram-negative Bacteria in Shandong Province: A Surveillance

目的 探讨山东省医院临床分离革兰阴性细菌对抗菌药物的耐药情况。方法 2 0 0 1年 12月～ 2 0 0 2年 12月间收集的山东省 10城市 12所医院临床分离菌 14 4 1株 ,其中革兰阴性杆菌 10 5 8株 ,占分离菌的 73.4 2 % ;采用标准平板 2倍稀释法 ,测定细菌 MIC,按照 NCCL S 2 0 0 0标准 ,计算 MIC50 、MIC90 ,判断敏感率、中介率、有效率。结果 在肠杆菌科细菌 ,帕尼培南细菌耐药率 0～ 1.1% ;头孢呋辛耐药 >30 % ;左氧氟沙星对大肠埃希菌耐药率 31.9% ;加酶抑制剂头孢菌素体外药敏试验耐药率 0～ 2 8.4 % ;哌拉西林 /他唑巴坦体外细菌耐药率0～ 32 .1% ;非发酵菌中铜绿假单胞菌对头孢他啶耐药率 2 0 % ,头孢哌酮 /舒巴坦为 19.1% ;不动杆菌属对帕尼培南耐药率 8.8% ;肠杆菌科细菌产 ESBL s分别为沙雷菌属 4 6 .8%、肺炎克雷伯菌 2 3.2 %、大肠埃希菌 19.6 %、阴沟肠杆菌 10 .7% ;产 Am p C酶分别为阴沟肠杆菌 17.4 %、大肠埃希菌 0 .9%。结论 山东地区肠杆菌科细菌产酶率低于国内其他地区 。

OBJECTIVE To evaluate the drug-resistance rates of bacteria isolated from outpatients or inpatients in Shandong Province. METHODS From Dec 2001 to Dec 2002, 1 441 pathogenic strains were isolated from (patients) in 12 hospitals from 10 cities in Shandong Province including 1 058 strains (73.42%) Gram-negative bacilli. International standard plate dilution method was used to determine the susceptibility test of (Gram-negative) bacilli in vitro. MIC_(50) and MIC_(90) detected to present the antibacterial activity of antimicrobial agents according to NCCLS (2001), and show the resistant, intermediate and susceptible rates of the bacteria to the compounds tested were calculated.RESULTS The resistant rates of Enterobacter to panipenem, cefuroxime, cefoperazone/sulbactam, piperacillin/tazobactam were 0-1.1%, >30%, 0-28.4%, 0-32.1%, respectively. The resistant rate of Escherichia coli to levofloxacin was 31.9%. The resistant rates of Resistance of Gram-negative Bacteria in Shandong Province: A Surveillance $$$$ DONG Liang, WU Da-wei, SUN En-hua, ZHANG Qi, CHEN Meng(Affiliated Qilu Hospital, Shandong University, Jinan 250012, China)Abstract: OBJECTIVE To evaluate the drug-resistance rates of bacteria isolated from outpatients or inpatients in Shandong Province. METHODS From Dec 2001 to Dec 2002, 1 441 pathogenic strains were isolated from (patients) in 12 hospitals from 10 cities in Shandong Province including 1 058 strains (73.42%) Gram-negative bacilli. International standard plate dilution method was used to determine the susceptibility test of (Gram-negative) bacilli in vitro. MIC_(50) and MIC_(90) detected to present the antibacterial activity of antimicrobial agents according to NCCLS (2001), and show the resistant, intermediate and susceptible rates of the bacteria to the compounds tested were calculated.RESULTS The resistant rates of Enterobacter to panipenem, cefuroxime, cefoperazone/sulbactam, piperacillin/tazobactam were 0-1.1%, >30%, 0-28.4%, 0-32.1%, respectively. The resistant rate of Escherichia coli to levofloxacin was 31.9%. The resistant rates of [WTBXPseudomonas aeruginosa to ceftazidime and cefoperazone/sulbactam were 20% and 19.1%, respectively. The rate of acinetobacter was (8.8%.) The rates of ESBLs producing Enterobacter cloacae, E. coli[W and Klebsiella pneumoniae were (46.8%,) (23.2%,) (19.6%,) respectively. The rates of AmpC producing E. cloacae and E.coli were 17.4% and 0.9%, (respectively.) CONCLUSIONS The rates of producing enzymes in Enterobacter in Shandong Province were lower than they were in other domestic areas. The resistant rate of E. coli to levofloxacin was lower than it in other domestic cities.