SEANIR监测中国15所教学医院不发酵糖革兰阴性杆菌对13种抗菌药物的药敏试验

Antimicrobial susceptibilitytesting of non-fermentative bacteria in 15 teaching hospitals in China:a report from SEANIR antimicrobial resistance surveillance 2008

目的分析SEANIR监测2008年中国15所教学医院医院获得性不发酵糖革兰阴性杆菌对抗菌药物的敏感性,并评价帕尼培南体外药敏试验方法。方法收集2008年分离自中国15所教学医院医院获得性感染患者的非重复鲍曼不动杆菌349株、铜绿假单胞菌359株、嗜麦芽窄食单胞菌145株和洋葱伯克霍尔德菌100株,用琼脂稀释法测定13种抗菌药物的MIC,对比MH培养基和1:40 MH培养基对帕尼培南药敏试验结果的影响。结果鲍曼不动杆菌对碳青霉烯类抗生素的敏感率仅为51.6%～63.7%;多黏菌素B和米诺环素对鲍曼不动杆菌的体外抑菌活性最强,且对亚胺培南耐药鲍曼不动杆菌仍具有较高的抑菌率(分别98.1%和72.8%)。多黏菌素B和阿米卡星对铜绿假单胞菌的抑菌率最高(分别为96.1%和83.3%),其次为用1:40 MH培养基测定帕尼培南、哌拉西林-他唑巴坦和美罗培南的抑菌率(72.4%～77.2%)。嗜麦芽窄食单胞菌和洋葱伯克霍尔德菌对米诺环素和甲氧苄啶-磺胺甲噁唑均较敏感(敏感率为78.6%～98.0%)。结论多黏菌素B对鲍曼不动杆菌和铜绿假单胞菌,米诺环素对鲍曼不动杆菌、嗜麦芽窄食单胞菌和洋葱伯克霍尔德菌,具有较强的体外抗菌活性。帕尼培南的体外药敏试验,鲍曼不动杆菌应采用MH培养基测定,铜绿假单胞菌应采用1:40 MH培养基测定,其抗菌作用与亚胺培南较为接近。

susceptibility was determined by agar dilution method. Both MH and 1 ： 40 MH medium were used when testing the suscepti- bility to panipenem. Results The percentage of A. baumannii susceptible to carbapenems ranged frona 51.6% to 63.7%. Poly- myxin B and minocycline showed the highest antimicrobial activity against A. baumannii. Even for the imipenem-resistant A. baumannii, there were still 98.1% and 72.8% of the strains susceptible to polymyxin B and minoeycline. Polymyxin B and amikacin were the most active antibiotics against P. aeruginosa （96.1 % and 83.3% susceptible, respectively）, followed by pa- nipenem determined with 1 ： 40 MH, piperacillin-tazobactam and meropenem （72.4% to 77.2% susceptible）. Minocycline and trimethoprim-sulfamethoxazole were the most active antibiotics against S. maltophilia and B. cepacia （78.6% to 77.2% sus- ceptible）. Conclusions Polymyxin B showed the highest antimicrobial activity against A. baurnannii and P. aeruginosa. Mino- eycline was most active against A. baumannii, S. rnaltophilia and B. cepacia. MH medium should be used when testing the antimicrobial susceptibility of A. baumannii to panipenem, but for P. aeruginosa the 1 ： 40 MH should be used.