摘要
目的:了解重症监护病房革兰阴性杆苗的分布及常用治疗中重度感染的抗菌药物对其的敏感性,指导临床用药。方法:采用浓度梯度法共测定11种抗菌药物对303株革兰阴性杆菌的体外抗菌活性。结果:在重症观察病房中革兰阴性杆菌常见病原菌为铜绿假单胞菌（29.7％）、大肠埃希菌（19.1％）、肺炎克雷伯菌（15.2％）、不动杆菌（8.6％）、嗜麦芽窄食单胞菌（6.9％）和阴沟肠杆菌（6.9％）。治疗铜绿假单胞菌感染的常用药物的敏感性同国内其他文献比较有一定程度下降。31％（18/58）的大肠埃希菌和15％（7/46）的肺炎克雷伯菌证实产ESBLs,ESBL菌合计的阳性率为24％。四代头孢菌素对于肠杆菌科细菌的敏感覆盖率较高于三代头孢菌素。对嗜麦芽窄食单胞菌敏感覆盖率较高的抗菌药是替卡西林/克拉维酸（95.2％）和头孢派酮/舒巴坦（90.2％）。对不动杆菌敏感覆盖率较高的抗菌药是亚胺培南（100％）和头孢哌酮/舒巴坦（61.5％）。结论:定期进行细菌耐药性的监测,有助于合理应用抗菌药物。
OBJECTIVE: To investigate the distribution and drug resistance of gram-negative bacilli in intensive care units. METHODS: 303 clinical isolates were tested in vitro susceptibility by Etest. RESULTS: The common bacteria in intensive care units were Pseudomonas aeruginosa (29.7%), Escherichia col i (1 9.1 %), Klebsiella pneumoniae( 1 5.2 %), Acinetobacter spp (8.6%), Stenophotomonas maltophilus (6.9%) and Enterobacter cloacae (6.9%). The susceptiveness of commonly used drug to Pseudonas aeruginosa were lower than other paper reported. The ESBL postive rate of Escherichia coli was 31% , Klebsiella pneumoniae was 15%, the total ESBL positive rate was 24% in the test. The fourth cephalosporin was more sensitive to Enterobacter than the third cephalosporin. The high susceptiveness of Stenophotomonas maltophilus were ticarcillin/clavulanic acid (95.2%) and cefoperazone/sulbactam (90.2%). The high susceptiveness of Acinetobacter spp. were imipenem (100%) and cefoperazone/sulbactam (61.5%). CONCLUSION: Monitoring the drug resistance of bacteria regular is helpful to application antibacterial reasonable.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2002年第3期177-181,共5页
The Chinese Journal of Clinical Pharmacology
