北京地区气单胞菌的流行状况及耐药性分析

Prevalence and antimicrobial resistance analysis of Aeromonas in Beijing

目的了解临床分离气单胞菌感染的分布特点及耐药性状况,为临床评估病情及合理选择抗菌药物提供客观依据。方法有感染临床表现患者的标本进行培养、分离和鉴定,同时用纸片扩散法测定气单胞菌对常用抗菌药物的敏感性,了解气单胞菌不同种感染的分布特点、对抗菌药物的耐药特点。结果气单胞菌感染主要发生于肠道,其次为血液和腹水。280株气单胞菌,温和气单胞菌112株占40%、嗜水气单胞菌79株占28.22%、豚鼠气单胞菌57株占20.36%、维隆气单胞菌16株占5.71%,其它气单胞菌16株占5.71%。感染主要发生于夏秋季,占87.86%。肠道气单胞菌对抗菌药物的耐药,以氨苄西林最严重为87.9%,其次为复方磺胺甲噁唑61.3%,头孢曲松29.4%,头孢美唑28.6%,对氯霉素、磷霉素及左氧氟沙星的耐药率均在10%以上。气单胞菌3个种对抗生素的耐药率比较,嗜水气单胞菌及豚鼠气单胞菌对头孢曲松、环丙沙星和头孢美唑的耐药率高于温和气单胞菌,肠道菌与血和腹水分离气单胞菌的耐药率比较,肠道菌对头孢曲松,左氧氟沙星,复方磺胺甲噁唑的耐药率明显高于血及腹水分离菌的耐药率(P<0.05)。结论北京地区气单胞菌感染以温和气单胞菌及嗜水气单胞菌为主,易发生于夏秋季节,致病性强,对抗生素的耐药较普遍,气单胞菌不同种及感染的不同部位对抗生素的耐药率有差别,临床医师应根据药敏试验结果区别对待。

Objective To enhance the knowledge of distribution feature and antibiotic resistance in Aeromonas species isolated from infected patients on pastients in order to offer the scientific gist for clinical analysing pathogenetic condition and adopting antibiotics treatment. Methods Bacteria were isolated and identified from samples in infected patients with clinical manifestation. Furthermore the sensitivity of Aeromonas to antimicrobial agents was measured by K-B according to CLSI and the distribution feature and antibiotic resistance of various Aeromonas species were analyzed. Results Aeromonas infected happened in enteron frequently, following up blood and ascites. Among 280 cases of Aeromonas, 87.86% occurred in summer and autumn. Aeromonas sobria was the most common species （40%） and Aeromonas hydrophila was secondary （28.22%） . Others were Aeromonas caviae （20.36%）, Aeromonas veronni （5.71%） and few species. The resistant rate to antimicrobial of Aeromonas species isolated from enteron was higher in ampicillin （87.9%）, trimethoprim-sulfamethoxazole （61.3%）, ceftriaxone （29.4%）, cefmetazole （28.6%）. The resistant rate to ceftriaxone, cefmetazole, ciprofloxacin of Aeromonas hydrophila and Aeromonas caviae was overtopping that of Aeromonas sobria. The resistance rate to ceftriaxone, levofloxacin, and trimethoprim-sulfamethoxazole of Aeromonas species isolated enteron was higher than that of blood and ascites.Conclusion Aeromonas sobria and Aeromonas hydrophila are majority species and occur in summer and autumn frequently in Beijing. The different resistant rate to some antimicrobial exist in various species and infected site so patients should be treated differently according to the susceptibility test.