Mohnarin 2006-2007年度报告：非发酵革兰阴性杆菌耐药性监测

目的了解2006~2007年度全国84家医院中非发酵革兰阴性杆菌的分布情况及对各类抗菌药物的耐药性。方法药物敏感性试验采用纸片扩散法,耐药性数据分析采用WHONET5.4软件进行统计分析。结果共收集非发酵革兰阴性杆菌分离株22983株,菌株数列前6位的菌种为假单胞菌属(48.2%)、不动杆菌属(31.4%)、嗜麦芽寡养单胞菌(11.5%)、伯克霍尔德菌属(2.9%)、金黄杆菌属(2.1%)和产碱杆菌属(1.4%)。铜绿假单胞菌对左氧氟沙星、哌拉西林、头孢哌酮/舒巴坦、环丙沙星、头孢吡肟、头孢他啶、哌拉西林/三唑巴坦、美罗培南和阿米卡星敏感性范围从56.3%至73.8%;不动杆菌对亚胺培南和美罗培南的敏感率分别为77.3%和75.6%;头孢哌酮/舒巴坦69.9%,米诺环素69.4%。不动杆菌对本次研究中的其它抗菌药物耐药率高于38.8%。嗜麦芽寡养单胞菌对米诺环素、复方磺胺甲口恶唑和左氧氟沙星的敏感性分别为96.8%、82.8%和82.2%;洋葱伯克霍尔德菌对米诺环素、复方磺胺甲口恶唑、头孢他啶和美罗培南的敏感性分别为89.3%、72.9%、65.4%和62.9%。结论非发酵菌在临床分离比重大,细菌耐药明显,临床应采取积极措施,合理使用抗菌药物,减少耐药菌发生。

2006～2007 Mohnarin report:Antibiotics resistance of non-fermenting Gram negative bacilli

Objective To investigate the distribution and antibiotic resistance of clinical isolates non-fermenting Gram negative bacilli in 84 China hospital from 2006 to 2007.Methods Antimicrobial susceptibility testing of clinical isolates was carried out by Kirby-bauer methods and data was applied for analysis by WHONET5.4.Results In 22,983 clinical isolates non-fermenting Gram negative bacilli,the most predominant pathogens were Pseudomonas spp.(48.2%),Acinetobacter spp.(31.4%),Stenotrophomonas maltophilia(11.5%),Burkholderia spp.(2.9%),Chryseobacterium spp.(2.1%),Alcaligenes spp.(1.4%).The susceptibility rates of Pseudomonas aeruginosa to levofloxacin,piperacillin,cefoperazone/sulbactam,ciprofloxacin,cefepime,ceftazidime,piperacillin/tazobactam,meropenem,and amikacin ranged from 56.3% to 73.8%.The susceptibility rates of Acinetobacter spp.to imipenem and meropenem were 77.3% and 75.6%,cefoperazone/sulbactam 69.9%,minocycline 69.4%,the resistance to other antimicrobial agents in this study was higher than 38.8%.The susceptibility rates of Stenotrophomonas maltophilia to minocycline,trimethoprim/sulfamethoxazol and levofloxacin were respectively 96.8%,82.8% and 82.2%;The susceptibility rates of Burkholderia cepacia to minocycline,trimethoprim/sulfamethoxazol,ceftazidime and meropenem were respectively 89.3%,72.9%,65.4% and 62.9%.Conclusions A nationwide surveillance data of bacterial resistance was most important and valuable for the guidance of rational selection of antimicrobial agents.