六安市2008年革兰阴性菌耐药性监测

Bacterial resistance surveillance in Lu′an city in 2008

目的:了解六安市2008年临床分离的革兰阴性菌耐药情况。方法:采用国际标准平皿琼脂对倍稀释法,对2008年9月从六安市3家医院临床分离的非重复的102株革兰阴性菌进行体外药敏试验,测定细菌的最低抑菌浓度,并按照美国临床实验室标准化研究所2008年的标准,计算细菌对抗菌药物的敏感率、中介率和耐药率。结果:102株革兰阴性菌中,大肠埃希菌27株,鲍曼不动杆菌25株,铜绿假单胞菌23株,肺炎克雷伯菌18株,嗜麦芽窄食单胞菌7株,其他2株;对碳青霉烯类抗菌药物最敏感,对哌拉西林/三唑巴坦(73.5%)也较敏感,其次较敏感的药物为阿米卡星(67.6%)、磷霉素(62.7%);耐药性高的药物依次是氨苄西林(96.1%)、头孢西丁(83.3%)、氨曲南(81.4%),对头孢哌酮/舒巴坦(51.0%)及头孢吡肟也有明显耐药性(39.4%)。结论:临床上应遵循《抗菌药物临床应用指导原则》合理应用抗菌药物,有指征地使用抗菌药物并应加强细菌耐药性监测,以防止细菌耐药性的蔓延。

Objective：To investigate the surveillance data of bacterial resistance in Lu＇an city hospitals in 2008. Methods：Bacterial susceptibility experiments were performed on 102 samples clinically collected from 3 hospitals in Lu＇ an city, using routine custom dilution MIC method according to the CLSI （ 2008 ） guidelines ; the resistance, intermediate and susceptible rates of the bacteria to antimicrobial agents were measured. Results： Among the 102 bacteria samples, Escherichia coli accounted for 27, Acinetobacter baumannii 25 ,Pseudomonas aeruginosa 23, Klebsiella 18, Stenotrophomonas maltophilia 7 and others 2. Carbapenems were the most effective antimicrobial agents against Gram-negative bacilli, and other effective ones were piperaeillin-tazobactam （73.5%）, amikacin （67.6%） and fosfomycin （ 62.7% ）. Gram-negative bacilli showed high resistance to ampieillin （ 96.1% ）, cefoxitin （ 83.3% ） and aztreonam （81.4%）, and were also noticeably resistant to cefoperazone/sulbactam （51.0%） and cefepime （39.4%）. Conclusions： We should administer antimicrobial drugs according to the ＂Guiding principles for the clinical use of antibacterial drugs＂ , and rationally choose antimicrobial agents in treatment of bacterial infections to control the bacterial resistance rates.