广州地区1998～2003年大肠埃希氏和肺炎克雷伯菌耐药性监测

Surveillance of Bacterial Resistance among E.coli and Klebsiella Pneumoniae in Guangzhou from 1998 to 2003

目的：了解广州地区大肠埃希氏和肺炎克雷伯菌的耐药状况。方法：对12家医院1998～2003年从各种临床标本收集的1646株大肠埃希氏菌和1175株肺炎克雷伯菌，用K—B纸片法进行药敏试验，测定这些菌株对21种临床常用抗生素的耐药性。结果：只发现一株大肠埃希氏菌对亚胺培南耐药，对大肠埃希氏菌耐药率在10％以下的抗生素分别为哌拉西林／三唑巴坦（6．2％）、头孢他啶（6．6％）、头孢哌酮／舒巴坦（8．4％）和阿米卡星（8．3％），对肺炎克雷伯菌耐药率在10％以下的抗生素只有头孢舭肟（9．8％）和头孢哌酮／舒巴坦（9．3％）。环丙沙星对大肠埃希氏菌的耐药率在70％左右，而肺炎克雷伯菌只有30％左右，肺炎克雷伯菌对阿米卡星和头孢他啶的耐药率明显高于大肠埃希氏菌，在头孢西丁耐药菌株中这种差异更加突出。结论：5a监测中，两类细菌对临床常用大部分抗生素的耐药性没有明显改变，但对部分抗生素的耐药性各有特性，对本地区细菌进行系统、全面的耐药性监测是很有必要的。

Objective： To investigate the resistance of E. coli and Klebsiella pneumoniae in Guangzhou from 1998 to 2003. Methods： 1646 strains E. coli and 1175 strains Klebsiella pneumoniae from 12 hospitals were tested by Kirby- Bauer method. Results：A strain E. coli was resistant to imipenem; The resistant rates of 1646 strains E. coli were as follows： piperacillin/tazoba 6. 2%, ceftazidime 6. 6%, cefoperazone/sulbac 8. 4%, amikacin 8. 3%. The resistant rates of 1175 strains Klebsiella pneumoniae to cefepime was 9. 8%, cefoperazone/sulbac 9. 3%. The resistant rate to ciprofloxacin..E, coli was 68.6% and Klebsiella pneumoniae was 32.8%. The resistant rate to amikacin and ceftazidime of Klebsiella pneumoniae were higher than E. coll. Conclusion：In vitro activities of most tested antimicrobial agents to E. coli and Klebsiella pneumoniae are steady from 1998 to 2003. Continual surveillance studies will be essential.