摘要
目的 调查我院重症监护病房革兰氏阴性杆菌耐药状况 ,了解超广谱 β 内酰胺酶 (ESBLs)菌株的发生率。方法 用E试验法测定 1 0 0株革兰氏阴性杆菌对 1 2种抗生素的最低抑菌浓度 (MIC)。结果 亚胺培南、ertapenem(MK 0 82 6)和阿米卡星对所有受试菌保持较高抗菌活性 ,细菌耐药率分别为 4 %、1 5 %和1 7% ;头孢他啶、头孢吡肟、头孢哌酮 /舒巴坦耐药率分别为 33 %、2 5 %和 2 6 % ,其他抗生素耐药率在 44 %～51 %。与 2 0 0 1年我院调查水平相比 ,头孢哌酮 /舒巴坦耐药率增加 1 5 % ,其他抗生素耐药率变化不大。用头孢噻肟 /头孢噻肟 +克拉维酸和头孢他啶 /头孢他啶 +克拉维酸分别筛选出ESBLs产生菌 1 3株和 1 1株 ,其中大肠埃希氏菌产酶率最高 ,分别为 2 1 7% (5/ 2 3)和 34 8% (8/ 2 3) ,肺炎克雷伯氏菌其次 ,分别为 2 3 8%(5/ 2 1 )和 9 5 % (2 / 2 1 )。抗菌活性最强的是亚胺培南 ,对所有大肠埃希氏菌和肺炎克雷伯氏菌ESBLs菌株都敏感。而临床常用的头孢哌酮 /舒巴坦和替卡西林 /克拉维酸并未体现酶抑制剂优越性 ,耐药菌株多。结论 亚胺培南抑菌率最高 ,对ESBLs产生菌有较强的抗菌活性 ,而加酶抑制剂抗生素的滥用 ,已造成细菌对其耐药率升高 ,且对付产酶耐药株感染逐渐失去优势。
Objective To investigate the Gram negative bacili resistant rates in ICU and learn the situation of ESBLs producing strains. Methods Using the E test to measure the minimum inhibitory concentration (MIC) of 12 antibiotics against 100 strains of Gram negative bacili. Results The drug resistance rates of imipenem, ertapenem and amikacin were 4%, 15% and 17%, respectively. Ceftazidime, cefepime and cefoperazone/sulbactam had a slightly higher resistant rates, which were 33%, 25%and 26%, respectively. The resistant rates of other eight antibiotics were among 44% to 51%.Compared with the survelliance in last year,the drug resistant rate of cefoperazone/sulbactam increased from 11% to 26%, while the others kept minor changes. 13 and 11 ESBLs producing strains tested by CTX/CTX+CA and CAZ/CAZ+CA respectively, showed the highest susceptibity to imipenem and the lower susceplibity to cefoperazone/sulbactam and ticarcillin/clavulanic acid. Conclusions Imipenem had the highest antibacterial activity and was also effective against ESBLs producing strains; the abusement of antibiotics with β lactamase inhibitors leads to increasement of the drug resistant rate.
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2002年第11期669-672,684,共5页
Chinese Journal of Antibiotics
