亚胺培南耐药菌株的耐药性及临床分布

目的:了解亚胺培南耐药菌株的分离情况、耐药性和流行分布。方法:2000年1月至2006年12月,收集该院临床各类标本中分离的耐亚胺培南菌株934株,采用V itek-32型微生物自动分析仪,对菌株进行鉴定及药敏试验。结果:该院亚胺培南耐药菌株的分离率从2000年的0~3.15%上升至2006年的18.9%~33.1%。其中非发酵菌占97.6%,以铜绿假单胞菌最多,占60.6%(553/912);其次是鲍曼不动杆菌,占28.5%(260/912)。最常见的感染部位是呼吸系统,痰、咽拭子等呼吸道标本的分离率最高,占76.7%,其他依次为脓性分泌物、体液、血液、尿液和导管等。耐亚胺培南的菌株对其他常用抗菌药物的耐药率均较高(35%~100%),其中以鲍曼不动杆菌对头胞哌酮/舒巴坦的耐药率最低(35%)。结论:耐亚胺培南菌株大多存在多重耐药性,甚至泛耐性,应根据药敏试验的结果选用敏感的抗菌药物进行治疗。

Distribution and drug-resistance of Imipenem-resistant strains

Objective: To investigate the isolation,distribution and drug-resistance of Imipenem-resistant strains.Methods: Totally 934 Imipenem-resistant strains were isolated from various specimens collected from January 2000 to December 2006 and the Vitek-32 system was applied to bacterial identification and susceptibility testing.Results:The isolation rates were increased from 0-3.15% in 2000 to 18.9%-33.1% in 2006.Among the 934 strains,97.6% were nonfermentative bacilli.P.aeruginosa and A.baumannii accounted for 60.6%(553/912)and 28.5%(260/912),respectively,with the highest isolation rate,76.7%,in the specimens from the respiratory tract.The susceptibility tests showed that these strains were multiresistant to commonly used antibiotics,with high resistance rates from 35% to 100%.Cefoperazone/sulbactam was the most active antibiotic against A.baumannii with the lowest resistance rate of 35%.Conclusion: Imipenem-resistant strains were mostly multi-drug resistant,even pan-drug resistant.Different antimicrobial therapy should be adopted according to the results of susceptibility tests.