临床常见病原菌对抗菌药物的耐药趋势分析

Tendency Analysis on Drug Resistance of Clinical Common Pathogenic Bacteria to Antibiotics

[目的 ]监测临床常见病原菌对常用抗菌药物的耐药性趋势 ,为临床合理应用抗菌药物提供依据。[方法 ]对我院 2 0 0 1年 1月至 2 0 0 3年 12月间常见病原菌耐药率进行统计分析。[结果 ]临床常见病原菌 :革兰阴性菌有大肠埃希菌、克雷伯菌属、铜绿假单胞菌、肠杆菌属、变形杆菌属 ;革兰阳性菌有表皮葡萄球菌、肠球菌、肺炎链球菌、金黄色葡萄球菌和腐生葡萄球菌。 3年间常用抗菌药物耐药总体呈上升趋势。大肠埃希菌对氨苄西林耐药率达 10 0 % ,对阿莫西林耐药率逐年上升 (4 3 2 %～ 10 0 % ) ;铜绿假单胞菌对头孢噻肟耐药率上升较快 (4 2 1%～ 80 0 % ) ;克雷伯菌属对环丙沙星的耐药率从 2 5 0 %升至 46 9% ,对阿米卡星的耐药率从 2 5 0 %升至 63 6% ;对表皮葡萄球菌耐药率呈逐年上升的抗菌药物有哌拉西林 (19 0 %～ 61 0 % )、舒他西林 (11 8%～ 5 5 6% )、阿莫西林 (4 5 5 %～ 10 0 % )、庆大霉素 (3 9 3 %～10 0 % ) ;肠球菌对环丙沙星的耐药率从 3 0 8%升至 71 8%。 [结论 ]临床医师要重视细菌耐药性监测工作 ,及时掌握细菌变迁及细菌耐药性变化动向 ,才能提高抗菌药物合理使用水平。

Objective\] To monitor drug resistance tendency of clinical common pathogenic bacteria to antibiotics for its reasonable using \ The resistance rates were analyzed (2001 2003) \ Common gram negative bacteria were escherichia coli, klebsiella species, pseudomonas, enterobacter species and proteus and Gram positive bacteria were staphylococcus epidermidis, enterococcus, streptococcus pneumoniae, staphylococcus aureus and saprophytic staphylococcal The rates were increasing during 3 years The rate of escherichia coli to ampicillin was up to 100%, and to amoxicillin increased annually (43 2%～100%);The rate of pseudomonas aeruginosa to cefotaxime increased quickly (42 1%～80 0%);The rates of klebsiella to ciprofloxacin were from 25 0% to 46 9% and to amikacin, from 25 0% to 63 5% The drugs to which the rates to staphylococcus epidermidis increased gradually were piperacillin (19 0%～61 0%), sultamicillin (11 8%～55 6%), amoxicillin (45 5%～100%) and gentamicin (39 3%～100%) The rate of enterococcus to ciprofloxacin increased from 30 8% to 71 8% \[Conclusion\] Physicians should pay attention to rate monitoring and improve antibiotics therapy