碳青酶烯类抗菌药物对常见非发酵革兰阴性杆菌体外抗菌活性的分析

Analysis Carbapenems activity in vitro against common nonfermnenting gram-negative bacilli

目的比较美罗培南和亚胺培南对铜绿假单胞菌和鲍曼不动杆菌的体外抗菌活性,为临床医生经验用药提供参考。方法采用K-B纸片法和MIC法对2004～2006年分离的铜绿假单胞菌587株和鲍曼不动杆菌226株进行药敏试验,结果按照CLSI2006标准判定,数据采用WHONET5.4和SPSS11.5进行统计分析。结果铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为43.4%和37.5%,P<0.01;鲍曼不动杆菌对亚胺培南和美罗培南的耐药率为40.7%和41.6%,P>0.05。结论非发酵菌对碳青酶烯类抗菌药物耐药问题越来越严重,该研究发现美罗培南对铜绿假单胞菌的耐药率低于亚胺培南,对鲍曼不动杆菌耐药率无统计学意义。美罗培南和亚胺培南对铜绿假单胞菌的耐药性存在差异,应该加强对这两种抗菌药物的监测。

[Objective]To compare the activity of Meropenem against Pseudomonas aeruginosa and Acinetobacter baumannii with Imipenem in vitro and provide the basis for physician＇s empiric treatment. [Methods] Kirby- Bauer disk diffusion and minimum inhibitory concentration （MIC） of the antibiotics were adopted to examine the 587 strains of P. aeruginosa, 226 strains of A. baumannii isolated from 2004 to 2006. Resistance was interpreted by CLSI2006 criteria. Data were analyzed by WHONET5.4 and SPSSI 1.5. [Results] The antibiotic resistant rates of imipenem and Meropenem against P. aeruginosa were 43.4% and 37.5% （P 〈0.01 ）, their rates against A. baumannii were 40.7% and 41.6%（P 〉0.05）. [Conclusions] Gram-negative nonfermenters resistant to carbapenems is more and more serious . This article shows that the antibiotic resistant rates of Meropenem against P. aeruginosa are lower than Imipenem and both antibiotics have no statistical differences for A. baumannii. It is better to select Meropenem from Carbapenems to treat severe infections of P. aeruginosa.