重症监护病房革兰阴性杆菌耐药性监测

Drug Resistance Surveillance of Gram-negative Bacteria in Intensive Care Unit

目的监测重症监护病房(ICU)革兰阴性杆菌的耐药状况,指导临床合理使用抗菌药物。方法对2005年1月-2006年2月ICU分离的245株革兰阴性杆菌按照全国临床检验操作规程进行签定,用K-B法做药敏试验,用确证法检测产超广谱β-内酰胺酶(ESBLs)。结果245株革兰阴性杆菌中占前3位的是铜绿假单胞菌(22.4%)、大肠埃希菌(20.8%)及肺炎克雷伯菌(16.3%),产ESBLs大肠埃希菌耐药谱分析,其酶型可能以CTX-M型为主。结论亚胺培南对肠杆菌科、非发酵菌保持了很强的抗菌活性,头孢哌酮/舒巴坦、头孢吡肟、头孢他啶、阿米卡星等抗菌药物也保持了较强的抗菌活性。

OBJECTIVE To investigate the drug resistance of Gram-negative bacteria in our hospital＇s intensive care unit（ICU）. It＇s important to apply rationally antibiotics in clinic. METHODS We recruited all samples from infected patients of ICU during from Jan 2005 to Feb 2006. Totally 245 strains were identified to be Gram-negative bacteria. Kirby-Bauer method was performed to test extended spectrum β-lactamases. RESULTS The first 3 of 245 strains were Pseudomonas aeruginosa （22.4 % ）, Escherichia coli （20.8 % ） and K lebsiella pneumoniae （ 16.3 % ）. Antibiogram analysis shew that CTX-M was the major type. CONCLUSIONS Imipenem keeps the highest sensitivity and antibacterial activity for Enterobacteriaceae and nonfermenters. Cefoperazone/sulbactam, cefepime, ceftazidime and amikacin keep the higher antibacterial activity.