常见革兰阴性杆菌对5种β-内酰胺类耐药率比较

Comparison of Drug Resistant Rates of Fiveβ-lactams Against Four Commom Gram-negative Bacilli

目的:比较常见4种革兰阴性杆菌对5种β-内酰胺类抗生素的耐药率,为临床合理用药提供参考。方法:用纸片扩散法对临床分析的革兰阴性杆菌进行药敏检测,比较其对5种β-内酰胺类抗生素的耐药率。结果:总体耐药率由低到高依次为美洛培南(8.74%)<哌拉西林/他唑巴坦(26.17%)<头孢吡肟(39.60%)<头孢他啶(39.60%)<氨曲南(43.75%)。不同的菌株对不同的抗生素各自的耐药率与总体耐药率存在一定差异。2007年与2006年药敏结果比较,总体抗菌药物耐药率显著上升(P<0.01)。结论:上述5种β-内酰胺类抗生素对革兰阴性菌具有较好的抗菌作用,但应根据菌种的不同合理选用,以减少细菌耐药性的产生。

Objective ： To compare the drug resistant rate of five β-lactams against four common gram-negative bacilli to provide reference for clinical usage. Method： An antimicorbial susceptibility testing was done on gram-negative bacilli isolated with Kirby-Bauer method. A comparison of five kinds of β-lactams antibacterial drug resistant rates was made. Result： Meropenem was the lowest drug resistant rate among the five β-lactams antibiotics, which was followed by pip- eracillin-tazobactam. The total drug resistance rates from low to high in order were meropenem （ 8.74% ）, piperacillin/ tazobactam （ 26.17 % ）, cefepime （ 37.89 % ）, ceftazidim （ 39.60% ）, and aztreonam （ 43.75 % ）. The total resistant rates varied from their respective resistance rate. The total resistant rates increased significantly （P 〈 0.01 ） from 2006 to 2007. Conclusion： All the five β-lactams have positive actions against gram-negative bacilli, but should be selected according to the kind of bacilli to reduce the drug resistance.