耐头孢他啶大肠埃希菌与肺炎克雷伯菌对氟喹诺酮类药物的耐药性分析

Drug resistance of ceftazidime-resistant Escherichia coliand Klebsiella pneumoniaeto fluoroquinolones antibiotics

目的了解临床耐头孢他啶大肠埃希菌与肺炎克雷伯菌分离株对氟喹诺酮类抗菌药物的耐药性,以合理使用氟喹诺酮类抗菌药物,采取有效措施控制耐药株的出现。方法采用K-B和MIC法测定耐头孢他啶大肠埃希菌与肺炎克雷伯菌对8种常见氟喹诺酮类抗菌药物的敏感性。结果共分离出耐头孢他啶大肠埃希菌与肺炎克雷伯菌276株,对加替沙星、莫西沙星、吉米沙星、左氧氟沙星、氧氟沙星、环丙沙星、帕珠沙星、司帕沙星的耐药率分别为46.38%、43.48%、42.72%、55.43%、65.22%、61.96%、52.54%、53.62%,且均明显高于头孢他啶敏感株(P<0.05);呼吸道、非呼吸道标本的耐头孢他啶大肠埃希菌与肺炎克雷伯菌分离株对加替沙星、莫西沙星、氧氟沙星、司帕沙星的耐药率不同,差异均有统计学意义(P<0.05)。结论耐头孢他啶大肠埃希菌与肺炎克雷伯菌分离株对氟喹诺酮类抗菌药物的耐药率较高,呼吸道、非呼吸道标本分离株对多种常见氟喹诺酮抗菌药物的耐药率不同。

OBJECTIVE To understand the drug resistance of ceftazidime-resistant Escherichia coli and Klebsiella pneumoniae strains to fluoroquinolones so as to reasonably use fluoroquinolones and take effective measures to control the drug resistant strains.METHODS The drug susceptibility testing for E.coli and K.pneumoniae to 8 common fluoroquinolone antimicrobial drugs were determined by K-B and MIC.RESULTS A total of 276 strains of ceftazidime-resistant E.coli and K.pneumoniae were isolated,the drug resistance rates to gatifloxacin,moxifloxacin,gemifloxacin,levofloxacin,ofloxacin,ciprofloxacin,pazufloxacin,and sparfloxacin were 46.38%,43.48%,42.72%,55.43%,65.22%,61.96%,52.54%,and 53.62%,respectively,significantly higher than that of the ceftazidime-sensitive E.coli and K.pneumoniae strains（P0.05）.The ceftazidime-resistant E.coli and K.pneumoniae isolated from the respiratory tract and those isolated from the non-respiratory tract specimens varied in the drug resistance rate to gatifloxacin,moxifloxacin,ofloxacin and sparfloxacin,the difference was statistically significant（P0.05）.CONCLUSION The clinical isolates of ceftazidime-resistant E.coli and K.pneumoniae are highly resistant to common fluoroquinolones,and the strains isolated from the respiratory tract and the strains isolated from the non-respiratory tract vary in the drug resistance rate to the common fluoroquinolones.