16种抗菌药物对来源于免疫功能低下患者的革兰氏阴性杆菌的体外抗菌活性比较

In vitro activity comparison of 16 antibacterial agents against Gram negative isolates from immunocompromised patients

对从武汉地区免疫功能低下患者分离的１０６３株革兰氏阴性杆菌，用琼脂平皿稀释法测定１６种抗菌药物的最小抑菌浓度（ＭＩＣ）。用ＷＨＯＮＥＴ－３计算机软件完成数据分析。主要革兰氏阴性杆菌是铜绿假单胞菌（３２．５％）、大肠杆菌（２２．９％）、克雷伯氏菌属（１４．３％）、肠杆菌属（７．９％）、不动杆菌属（６．１％）和柠檬酸菌属（４．９％）。通过ＭＩＣ测定显示大部分菌株对１６种抗菌药物有不同程度的耐药性。４７．２％的菌株同时对５种以上抗菌药物耐药。１０６３株革兰氏阴性杆菌对亚胺培南／西司他丁最敏感，其次是对阿米卡星和头孢他啶，敏感率分别为９５％、８８％和８６％。亚胺培南／西司他丁的体外抗菌活性最高，ＭＩＣ５０和ＭＩＣ９０为０．５和２μｇ／ｍｌ，阿米卡星（ＭＩＣ５０和ＭＩＣ９０为２和６４μｇ／ｍｌ）及头孢他啶（ＭＩＣ５０和ＭＩＣ９０为２和３２μｇ／ｍｌ）次之。根据对１６种药物抗菌活性的比较。

The minimum inhibitory concentrations (MIC) of 16 antibiotics against Gram negative isolates from immunocompromised patients in Wuhan were determined by agar dilution method and the susceptibility rates of the isolates to these antibiotics were analyzed. A WHONET 3 computer software was used to analyse the results. The main organisms were P.aeruginosa (32.5%), E.coli (22.9%), Klebsiella (14.3%), Enterobacter (7.9%), Acinetobacter (6.1%), and Citrobacter (4.9%). It was found that most isolates possessed resistance to 16 antibiotics in various degree. 47.2% strains were resistant to more than 5 antibiotics. Among 16 antimicrobial agents, the suscepibility rate of the isolates to imipenem/cilastatin was the highest (95%), to amikacin (88%) and to ceftazidime (86%) followed. The MIC 50 (MIC 90 ) of imipenem/cilastatin, amikacin and ceftazidime were 0.5 (2), 2 (64) and 2 (32) μg/ml respectively. The results suggested a rational regimen for treatment of Gram negative bacteria infections in immunocompromised patients.