临床常见革兰阴性杆菌耐药趋势分析

[目的]对我院微生物实验室2003～2004年分离的常见革兰阴性杆菌进行耐药性对比分析，为临床感染性疾病的抗菌药物选择及调整提供实验依据。[方法]1810临床分离的革兰阴性菌用VITEK-32、GNS-506、GNS-120药敏卡进行药敏试验。[结果]1810株革兰阴性菌中，最常见的菌种依次为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、肠杆菌属、不动杆菌属、变形杆菌属。产超广谱β-内酰胺酶（ESBLs）的大肠埃希菌由2003年35.9％下降到2004年的32.0％；产ESBLs肺炎克雷伯菌由2003年的33.6％下降到2004年的23.6％。三、四代头孢菌素及氨曲南对大肠埃希菌和肺炎克雷伯菌耐药性2004年较2003年有程度不等的下降。亚胺培南和哌拉西林/他唑巴坦对革兰阴性杆菌有极强的抗菌作用。[结论]临床医生高度重视合理应用抗生素，收到可喜的效果。通过对耐药性监测研究使我们提高抗生素耐药性问题的认识，为抗生素使用和调控提供基础。

Trend in drug resistance of common clinical Gram - negative bacillus isolates

[Objective] To investigate the drug resistance of common clinical Gram - negative bacillus isolates in our hospital from 2003 to 2004 to provide basis for reasonable use of drugs in clinical practice. [Methods] The drug susceptibility of 1810 Gram-negative bacillus isolates was determined by VITEK -32, GNS -506 and GNS - 120 cards. [ Results] The common pathogens were E.coli, P. aeruginosa, K. pneumoniae, Enterobacter spp, Acinetobacter spp and Proteus spp. From 2003 to 2004, the percentage of ESBL-producing E.coil decreased form 35.9% to 32.0% and that of ESBL - producing K. pneumoniae decreased from 33.6% to 23.6%. The drug resistant rate of E. coil and K. pneumoniae to third-and fourth - generation cepholosporins and aztreonam was slightly decreased in 2004 as compared with that in 2003. Imipenem and piperacilin - tazobactam showed excellent activity against Gram-negative bacilli.[Conclusion] The physicians should be aware of the importance of reasonable use of drugs in clinical practice. The detection of drug resistance of bacilli to antibiotics is helpful for use of drugs.