摘要
目的 分析近 2年 12 47株非发酵菌感染临床分布特点及耐药情况 ,探讨合理使用抗菌药物。方法 用 VITEK- AMS微生物自动鉴定仪鉴定到种 ,药敏试验采用其配套的 GNS- KI或 GNS- 2 0 1卡测定 17种抗菌药物抑菌浓度 ,按 NCCL SM7解释结果 ,并采用微量稀释法检测 10种抗菌药物 MIC90 。结果 非发酵菌占临床总细菌分离率 2 8.8% ,其中乙酸钙不动杆菌最多 (4 2 .74% ) ,其次为铜绿假单胞菌与嗜麦芽黄单胞菌 ,分别为 35 .2 8%与 6 .89%。83%感染患者伴有各种基础疾病 ,96 %患者存在各种高危因素。非发酵菌分布部位以呼吸道分离率最高 (6 3.4% ) ,其次为创面分泌物 (12 .18% ) ,泌尿道占 8.2 6 %。分离的菌株对氨苄西林、庆大霉素、第二代头孢菌素、喹诺酮类等多种抗菌药物耐药为 5 0 %～ 10 0 %。头孢他啶耐药率较其他第三代头孢菌素低 ,但它们之间无显著差异 (P>0 .0 5 ) ,而含酶抑制剂复方型抗菌药物哌拉西林 /三唑巴坦、替卡西林 /克拉维酸、头孢哌酮 /舒巴坦、亚胺培南 /西司他丁 (嗜麦芽黄单胞菌除外 )及哌拉西林、阿米卡星对非发酵菌耐药率低 (8.2 %～ 32 .8% ) ,与第三代头孢菌素及其他抗菌药物相比有显著差异 (P<0 .0 5 )。结论 非发酵菌耐药率高 ,治疗非发酵菌感染宜选用敏感抗菌药物治疗 ,同时应?
Objective: To analyse clinical distribution and drug resistance of 1247 strains of nonfermenters (NF), to propose the appropriate use of antibiotics. Methods: The bacteria strains were identified by VIEK AMS to species. 17 antibiotics susceptibility were done with affix GNS KI or GNS 201 cards. The results were determined according to NCCLSM 7. Results: The NF strains: Acetate acinetobacter was 42.7%, Pseudomonas aeruginosa was 35.28% and Xanthomonas maltophilia (XM) was 6.89%. 83% of cases with nonfermenter infections had various underlying diseases, and 96% of them with various high risk factors. The local distribution of the strains is as follows: respiratory tract (63.4%); wound surface secretion (12.18%); urinary tract (8.26%). The resistant rates of all strains against ampicillin, gentamicin, the second generation cephalosporins and fluoroqunolones were 50% to 100%. The resistant rate to ceftazidine was lower than other third generation cephalosporins. But it′s not statistically significant ( P >0.05). The resistant rates of combined antibiotics which contain enzyme inhibitors, such as piperacillin/tazobactam, ticarcillin/clavulanate, cefoperazone/sulbactam, imipenem/cilastatin (exclude XM), piperacillin and amikacin were 8.2%~32.8%. These resistant rates were significantly lower than those of the third genertion cephalosporins and other antibiotics ( P <0.05). Conclusions: The resistant rates of NF were very high. It is recommended to choose sensitive anitbiotics to treat NF infections.
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2001年第5期362-364,392,共4页
Chinese Journal of Antibiotics
