住院患者病原菌的耐药性分析

目的：调查2001年7月—2002年7月天津某三级甲等医院住院患者病原菌耐药性。方法：采用K—B法测定住院患者临床分离株的药物敏感性。结果：住院患者最常见的临床分离株为大肠埃希菌(13．7％)、铜绿假单胞菌(9．2％)、肺炎克雷伯菌(7．5％)、不动杆菌(5．1％)和金黄色葡萄球菌(5．8％)。革兰阴性杆菌占68．6％。亚胺培南、头孢吡肟、头孢哌酮一舒巴坦和阿米卡星对革兰阴性杆菌抗菌活性好。大肠埃希菌对左氧氟沙星等氟喹诺酮类耐药率超过60％，对头孢噻肟等部分药物耐药率已接近或超过30％。金黄色葡萄球菌对苯唑西林耐药率达43．6％，且均为多重耐药菌株，未发现对万古霉素耐药的金黄色葡萄球菌。结论：住院患者广谱抗菌药物使用广泛，临床医师应关注细菌耐药性变化，合理使用抗菌药物。     

Occurrence of integrons and antimicrobial resistance genes among Salmonella enterica from Brazil

OBJECTIVES: To determine the occurrence of antimicrobial resistance genes and role of integrons among 135 antimicrobial-resistant Salmonella enterica from Brazil. METHODS: The presence of antimicrobial resistance genes, class 1 and 2 integrons and gene cassettes was analysed by PCR and sequencing. The genetic location of class 1 integrons was determined in 25 isolates by hybridization and plasmid transfer experiments. RESULTS: Fifty-five of the isolates were positive for class 1 integrons. Integron-positive isolates represented 17 different serovars and were mainly from human (n=28) and animal (n=13) sources. The gene cassette arrangements could be determined in 51 of the positive isolates, which harboured one [dfrA22, aadA1 or orf3 (putative trimethoprim resistance)], two [aadA1-dfrA1, aac(6')-Ib-orf1 (unknown function) or aacA4-aadA1], three [dfrA15b-cmlA4-aadA2, orf2 (unknown function)-dfrA5-orfD] or four [orf4-aacA4-blaOXA-30 (interrupted by an IS1 element)-aadA1] cassettes in their variable region. Only one isolate harboured a class 2 integron with the gene cassette array dfrA1-sat-aadA1. Several integron unrelated resistance genes were also detected in the isolates. Sulphonamide resistance was primarily mediated by sul2 and sul3, tetracycline resistance by tet(B) and tet(A), chloramphenicol resistance by catA1, streptomycin resistance by strA and ampicillin resistance by blaTEM. blaCTX and blaCMY-2 were found in cephalosporin-resistant isolates. Mating and hybridization experiments demonstrated that a high-molecular-weight plasmid mediated the gene transfer of integrons and additional resistance determinants. CONCLUSIONS: The present study revealed that integron-mediated resistance genes contributed to the multiresistance phenotype observed in the isolates, but most resistance genes were located outside the integron structure, as independent genes. However, they might be located on the same conjugative plasmid.     

临床血培养分离病原菌耐药性分析

目的了解医院血培养阳性标本检出的病原菌构成和耐药情况,为临床血流感染诊疗提供参考。方法采用法国生物梅里埃公司的VITEK2-COMPACT全自动微生物分析仪对菌株进行鉴定和药物敏感性分析,BacT/Alert3D全自动血液培养仪进行血培养,并归纳医院2011年1月至2012年10月697株临床血液检出菌及药敏结果。结果共检出697株病原菌,其中革兰阴性杆菌376株（53.95%）;革兰阳性球菌284株（40.75%）;真菌23株（3.30%）;革兰阳性杆菌14株（2.01%）。产ESBLs大肠埃希菌检出率59.32%,产ESBLs肺炎克雷伯菌检出率26.15%,未检出碳青酶烯耐药肠杆菌科细菌。铜绿假单胞菌对碳青酶烯类、氨基糖苷类、喹诺酮类、头孢他啶和头孢吡肟的耐药率均小于40%,泛耐药铜绿假单胞菌检出率19.44%;鲍氏不动杆菌的耐药性高于铜绿假单胞菌,除阿米卡星和氨苄西林/舒巴坦外,对检测的其余抗菌药物耐药率均大于50%,泛耐药鲍氏不动杆菌检出率48.00%。葡萄球菌和肠球菌对万古霉素、替加环素、利奈唑烷、喹奴普汀/达福普汀高度敏感;真菌对所有抗真菌药物的耐药率均小于10%。结论引起医院患者血流感染的病原菌以革兰阴性杆菌和革兰阳性球菌为主,耐药菌株常见,检出泛耐鲍曼不动杆菌和铜绿假单胞菌,未检出碳青酶烯耐药肠杆菌和万古霉素耐药葡萄球菌和肠球菌。     

血液病患者尿路感染病原谱及耐药性分析

目的：了解血液病患者尿路感染病原谱特点及耐药性,为临床合理选用抗菌药物治疗血液病患者尿路感染提供参考。方法对医院血液科2011年1月至2013年12月血液病患者尿培养标本分离的病原性细菌分布及耐药性进行分析,头孢噻肟／克拉维酸双纸片表型法筛选产超广谱β‐内酰胺酶（ESBLs）菌。结果共分离595株病原菌,426株革兰阴性菌,占71．6％。大肠埃希菌是居首位的病原菌,占33．4％。大肠埃希菌和肺炎克雷伯菌中产超广谱β‐内酰胺酶（ESBLs）菌的检出率分别为83．9％、82．8％。粪肠球菌与屎肠球菌检出率分别为7．9％和17．8％。结论血液病患者尿路感染主要病原菌以革兰阴性菌为主,表现为尿路感染产 ESBLs 肠杆菌科菌非常严重,应引起重视,根据敏感性试验选择合理抗菌药治疗尿路感染。     

2007-2011年临床分离病原菌结构及其耐药性变迁

目的了解苏州市立医院本部近5年临床分离病原菌分布及其耐药性变迁。方法回顾性分析2007年1月—2011年12月临床分离病原菌资料。结果 5年间本院分离出的病原菌数目不断增加,以革兰阴性菌（55.1%）为主,革兰阳性菌（26.9%）和真菌（18.0%）次之。大肠埃希菌、白色假丝酵母菌、铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌居检出菌的前五位。鲍曼不动杆菌每年呈快速增长之势,肠球菌属细菌感染近年也有明显增长,真菌构成比率偏高。耐甲氧西林葡萄球菌检出率在55.7%-79.1%。5年共分离到10株耐万古霉素肠球菌。肠杆菌科细菌中产ESBLs大肠埃希菌比率在50.2%-62.1%,肺炎克雷伯菌比率在42.3%-57.8%,首次分离到碳青霉烯类不敏感肠杆菌科细菌。耐碳青霉烯类铜绿假单胞菌比率在47.5%-60.9%。不动杆菌对多种抗菌药物的耐药性增长迅速,耐碳青霉烯类鲍曼不动杆菌比率逐年快速增长（11.9%-61.2%）。结论临床分离的病原菌构成比不断发生变化,鲍曼不动杆菌及肠球菌不断增多。多重耐药菌控制形势依然严峻。     

2010~2011年血培养病原菌分布和耐药性分析

目的 研究该院2010~2011年血培养病原菌分布及耐药性.方法 回顾性分析该院2010~2011年血培养标本病原菌检出情况及其药敏试验结果.结果 10 128例血培养标本共检出病原菌1 276株,革兰阴性杆菌、革兰阳性球菌及真菌分别占57.1%(728/1 276)、33.4%(426/1 276)、9.5%(121/1 276).革兰阳性球菌以表皮葡萄球菌、金黄色葡萄球菌、肠球菌等为主,对万古霉素、替考拉宁和利奈唑胺均敏感;粪肠球菌耐药率低于屎肠球菌.革兰阴性菌以大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌为主;超广谱β内酰胺酶阳性肠杆菌科细菌耐药率高于阴性株.碳青霉烯类对大肠埃希菌、肺炎克雷伯菌的抗菌活性强于铜绿假单胞菌、鲍曼不动杆菌.真菌以白色假丝酵母菌为主.结论 2010~2011年该院血液感染患者较多,应重视血培养标本检测及致病菌耐药性分析,应根据药敏实验结果 及耐药趋势合理应用抗菌药物.     

儿童血培养的病原菌分布及耐药性分析

目的 分析住院患儿血培养的病原菌分布及耐药特点,指导临床抗菌剂的合理应用.方法 采用BACTEC 9240全自动血培养仪和MicroScan WalkAway 96SI全自动微生物鉴定系统进行病原菌的培养和鉴定,用K-B法进行细菌药敏实验.结果 5 750例血培养中379例检出阳性,阳性率为6.59%.共检出病原菌381株,包括革兰阳性菌260株,占68.24%;革兰阴性菌81株,占21.26%;真菌40株,占10.50%.按年龄分组,各年龄段患儿检出的病原菌均以凝固酶阴性葡萄球菌居多,又各有其分布特点;凝固酶阴性葡萄球菌对万古霉素、利奈唑胺和替考拉宁敏感,对β-内酰胺类和大环内酯类耐性率高(>80.00%);大肠埃希菌和肺炎克雷伯菌均未分离出亚胺培南耐药菌株,两者对头孢菌素类抗菌剂耐药严重.结论 儿童血培养分离的病原菌以革兰阳性菌为主,常见的病原菌凝固酶阴性葡萄球菌、大肠埃希菌和肺炎克雷伯菌均对多数常用抗菌剂耐药严重.     

902例尿培养菌群分布及耐药性分析

目的调查宣城中心医院尿路感染的菌群分布及耐药性,为临床感染预防及合理用药提供依据。方法对安徽省宣城中心医院2010年6月至2012年5月门诊及住院患者尿液的细菌培养、药物敏感试验结果进行总结分析,并与已报道的结果进行比较。结果 902例患者标本共分离出296株(32.8%)病原菌,其中革兰阴性菌178株(60.1%),最常见为大肠埃希菌134株(45.3%),肺炎克雷伯菌18株(6.1%)、变形杆菌12株(4.1%);革兰阳性菌72株(24.3%),最常见为凝固酶阴性葡萄球菌37株(12.5%)及屎肠球菌20株(6.7%);此外还检出真菌46株(15.5%)。结论尿路感染以革兰阴性菌感染较高,真菌的分离率呈上升趋势,不同病原菌敏感药物存在较大差异,建议用药前进行药物敏感性试验。     

Genetic elements involved in the acquisition of antimicrobial resistance genes in bacteria

A variety of genetic elements play key role in the dissemination of antimicrobial resistance genes among gram-negative bacteria. Transposons can transfer resistance genes intracellularly, while conjugative plasmids carrying resistance genes can move from one bacterial cell to another. Integrons are genetic elements that can collect several resistance genes in the form of gene cassettes. These genetic elements sometimes coexist and work cooperatively. For example, integrons, which is not mobile by themselves, can obtain an ability to transfer when they are incorporated into transposons. Recent reports suggest that integrative and conjugative elements, hybrid elements of conjugative plasmids and phages, also contribute to the dissemination of resistance genes among gram-negative bacteria.     

Recording of antimicrobial resistance of urinary tract isolates--effect of repeat samples on resistance levels

The effect of including repeat urine samples on the trimethoprim resistance level of urinary tract isolates in outpatients and inpatients has been studied on the basis of consecutive urinary tract isolates collected in the Turku City Hospital in 1982 and from outpatients in the Turku area in 1984. In the Turku City Hospital trimethoprim resistance occurred in 49.1% of all strains studied and when repeat samples from the same patients were excluded only in 39.4% (P less than 0.001). In outpatients, the corresponding figures were 17.5% and 15.7%, respectively (P greater than 0.10). These findings call for care to exclude repeat urine samples especially in those collected from inpatients. The effect of catheter isolates on the resistance figures and division of samples according to the patients' age are also discussed.     

血培养阳性结果细菌分布及耐药性

目的对大化集团公司职工医院近4年来的血培养阳性率、细菌分布及其对药物的敏感情况进行回顾性分析,为临床合理使用抗菌药物提供用药依据。方法血培养标本用Bact／Alert2120自动血细胞分析系统和Vitek60鉴定仪进行血培养及鉴定,药敏用K—B法,用Whonet5软件进行分析。结果1747例血培养标本分离出细菌258株（14．77％）,其中革兰阴性菌148株（57．36％）;革兰阳性菌110株（42．64％）。感染率最高的细菌是大肠埃希菌、甲型副伤寒菌、伤寒沙门菌及非金黄色葡萄球菌。结论肠杆菌科细菌和葡萄球菌是血培养中的主要病原菌,而产超广谱β-内酰胺酶菌株、耐甲氧西林金黄色葡萄球菌、耐甲氧西林凝固酶阴性葡萄球菌耐药严重,提示应高度重视,合理使用抗菌药物,减少细菌耐药性产生,以提高临床治疗效果。     

Prevalence and antimicrobial resistance patterns of Aeromonas strains isolated from drinking water samples in istanbul, Turkey

The aim of this study was to determine the prevalence and the resistance patterns of Aeromonas spp. in drinking water in Istanbul, Turkey. We investigated a total of 1,680 drinking water samples (840 tap water and 840 domestic water tank samples) for Aeromonas strains between June 2002 and October 2005. A total of 147 Aeromonas strains were isolated from 49 (6%) of 840 tap water samples and from 98 (12%) of 840 domestic water tank samples. Antibiotic susceptibility of Aeromonas strains was determined by the disc diffusion method, according to the CLSI (Clinical Laboratory Standards Institute) recommendation. Among the 147 Aeromonas strains, the prevalence was: A. hydrophila 68 (46%), A. sobria 50 (34%), A. caviae 11 (8%), A. salmonicida 9 (6%), A. veronii 5 (3%) and A. jandaei 4 (3%). Approximately 55% of the strains were resistant to ampicillin, 48% to erythromycin, 41% to amoxicillin-clavulanic acid, 28% to ceftazidime, 27% to cefoxitin, 26% to ceftriaxone and cefotaxime, 22% to piperacillin, 14% to trimethoprim-sulfamethoxazole, 12% to tetracycline, 11% to aztreonam, 8% to meropenem, 6% to imipenem, 2% to nalidixic acid, 1% to ciprofloxacin, tobramycin and gentamicin. None of the strains were resistant to amikacin and netilmicin. In conclusion, Aeromonas spp. isolated from drinking water in Istanbul have a resistance potential and the antibiotic resistance rates of A. hydrophila, A. sobria and A. caviae were usually higher than those of other Aeromonas strains. It should be kept in mind that these microorganisms in drinking water might be a potential risk for public health.     

临床常见病原菌对喹诺酮类抗菌药物的耐药性分析

目的 探讨该院临床常见病原菌的菌群分布及对喹诺酮类抗菌药物的耐药性,指导临床合理使用抗菌药物.方法 对2015-2019年该院住院及门诊患者临床感染标本进行病原菌培养,采用VIT EK 2 Com-pact系统进行细菌菌种鉴定、药敏试验,采用WHONET5.6软件进行数据统计分析.结果 5年内共分离到27663株非重复致病菌株,其中革兰阴性菌20931株(75.66％),革兰阳性菌6732株(24.34％).菌株主要来源于痰、创口分泌物/组织、血液和尿液等临床标本.药敏试验结果显示,喹诺酮类抗菌药物耐药率最高的前3位细菌分别为屎肠球菌、鲍曼不动杆菌和大肠埃希菌;产碳青霉烯酶和产超广谱β-内酰胺酶的大肠埃希菌、肺炎克雷伯菌对2种喹诺酮类抗菌药物(环丙沙星和左氧氟沙星)的耐药率均高于不产酶菌株(P<0.01);耐甲氧西林的葡萄球菌对3种喹诺酮类抗菌药物(环丙沙星、左氧氟沙星和莫西沙星)的耐药率明显高于甲氧西林敏感菌株(P<0.01).结论 临床分离的常见病原菌对喹诺酮类抗菌药物的耐药性差异较大,应加强细菌耐药性及产酶菌株的监测,加强抗菌药物管理,减少耐药菌株的产生和传播.     

Occurrence of the new tetracycline resistance gene tet(W) in bacteria from the human gut

Members of our group recently identified a new tetracycline resistance gene, tet(W), in three genera of rumen obligate anaerobes. Here, we show that tet(W) is also present in bacteria isolated from human feces. The tet(W) genes found in human Fusobacterium prausnitzii and Bifidobacterium longum isolates were more than 99.9% identical to those from a rumen isolate of Butyrivibrio fibrisolvens.     

湖北地区儿科患者血培养阳性病原菌的耐药性监测

目的 了解近年湖北地区三级医院儿科患者血培养中病原菌的分布及其耐药性.方法 收集2006-2007年湖北地区17所三级医院儿科患者血培养阳性分离的病原菌,用常规方法 分离鉴定细菌,药敏试验采用纸片扩散法(K-B法).结果 2006年1-12月血培养分离菌941株,细菌依所占比率多少依次为凝固酶阴性葡萄球菌573株(60.9%),金葡菌127株(13.5%),粪肠球菌33株(3.5%),大肠埃希菌16株(1.7%).2007年1-12月血培养分离菌969株,依次为凝固酶阴性葡萄球菌583株(60.2%),金葡菌162株(16.7%),粪肠球菌28株(2.9%),大肠埃希菌21株(2.2%),屎肠球菌11株(1.1%),猪霍乱沙门菌猪霍乱亚种11株(1.1%).2006年MRSA的检出率为71.7%,产ESBLs大肠埃希菌的检出率为56.2%.2007年MRSA的检出率为79.6%,产ESBLs大肠埃希菌的检出率为47.6%.耐甲氧西林的葡萄球菌对常用抗生素的耐药率明显高于对甲氧西林敏感的葡萄球菌,未发现对万古霉素和替考拉宁耐药的葡萄球菌.结论 湖北地区三级医院儿科患者血培养检出的病原菌主要以葡萄球菌属为主,且存在严重的耐药问题.     

A surveillance study of antimicrobial resistance of gram-negative bacteria isolated from intensive care units in eight hospitals in Turkey

This study was carried out with the participation of eight hospitals in Turkey to determine the frequency of gram-negative bacteria isolated in intensive care units (ICU) and to compare their resistance rates to selected antibiotics. Aerobic gram-negative bacteria isolated from ICUs during 1996 were studied. Antibiotic susceptibilities to imipenem, ceftazidime, ceftazidime-clavulanate, ceftriaxone, cefotaxime, cefepime, cefodizime, cefuroxime, piperacillin/tazobactam, amoxycillin-clavulanate, gentamicin, amikacin and ciprofloxacin were determined by Etest. A total of 748 isolates were obtained from 547 patients. The majority of organisms were isolated from the respiratory (38.8%) and urinary tracts (30.9%). Pseudomonas spp. were the most frequently isolated gram-negative species (26.8%), followed by Klebsiella spp. (26.2%). Escherichia coli, Acinetobacter spp. and Enterobacter spp. were the other commonly isolated organisms. High resistance rates were observed for all antibiotics studied. Imipenem appeared to be the most active agent against the majority of isolates. Although resistance rates exceeded 50%, ciprofloxacin, cefepime and amikacin were found to be relatively effective. Extended-spectrum beta-lactamase (ESBL) production appeared to be a major mechanism of resistance to beta-lactam antibiotics. In contrast to ceftazidime-clavulanate, piperacillin/tazobactam showed poor activity against organisms thought to produce ESBL, suggesting the presence of an enzyme resistant to tazobactam action. This study has yielded high rates of resistance in aerobic gram-negative isolates from ICUs in Turkey. High resistance rates to all the other antibacterials studied leave imipenem as the only reliable agent for the empirical treatment of ICU infections in Turkey.     

4380株医院感染病原菌的临床分布及耐药性分析

目的了解4 380株医院感染病原菌的临床分布及其耐药性。方法对重庆市急救医疗中心住院患者的标本按常规进行病原菌分离、鉴定和抗菌药物敏感性试验,结果用WHONET5.6软件进行分析。结果医院感染检出率前5位的科室为神经外科、神经内科、创伤科、肿瘤科和中心重症监护病房;7 326例临床送检标本中,分离到4 380株病原菌,检出率约为59.8%,其中革兰阴性杆菌占75.3%(3 300/4 380),革兰阳性球菌占19.0%(831/4 380),真菌占5.7%(249/4 380),排名前10位病原菌依次为:铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌、白色念珠菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌、肠球菌属、阴沟肠杆菌、洛菲不动杆菌。耐甲氧西林金黄色葡萄球菌(MRSA)检出率为49.1%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率为81.2%,均未检出对糖肽类耐药的葡萄球菌,产超广谱β-内酰胺酶(ESBLs)阳性的大肠埃希菌检出率为58.9%,ESBLs阳性肺炎克雷伯菌检出率为28.9%。结论多种因素致患者免疫力低下,是条件致病菌引起医院感染的主要原因;病原菌以革兰阴性杆菌为主,其中铜绿假单胞菌上升尤为明显,真菌感染比例也有明显上升趋势。肠杆菌科细菌对碳青霉烯酶类、阿米卡星和哌拉西林/他唑巴坦等抗菌药物耐药率较低,铜绿假单胞菌和鲍曼不动杆菌呈现多重耐药趋势。     

2007年和2009年医院内获得性血流感染病原菌分布及其耐药性分析

目的监测2007年和2009年我国不同地区13家教学医院内获得性血流感染中主要病原菌的分布并对其耐药性进行分析。方法收集医院内获得性血流感染的病原菌,并对其进行药物敏感性检测,采用WHONET5.6软件对数据进行分析。结果本研究共收集到2015株医院内获得性血流感染病原菌,其中革兰阴性杆菌1332株(占66.1%),革兰阳性球菌683株(占33.9%)。分离率排名前五位的病原菌分别为:大肠埃希菌(27.9%),肺炎克雷伯菌(11.3%),金黄色葡萄球菌(10.9%),铜绿假单胞菌(7.0%),鲍曼不动杆菌(6.0%)。对血流感染中常见革兰阴性杆菌体外药物敏感率较高的抗菌药物依次为:替加环素(98.2%,不包括铜绿假单胞菌),多黏菌素(98.1%,非发酵菌),头孢他啶/克拉维酸(90.4%);对常见革兰阳性球菌体外药物敏感率较高的抗菌药物有:替加环素和利奈唑胺(敏感率均为100%),万古霉素和替考拉宁(敏感率均为99.4%)。2007年度和2009年度数据显示:苯唑西林耐药金黄色葡萄球菌(MRSA)的发生率分别为42.3%和42.2%,产超广谱β-内酰胺酶肠杆菌科细菌(ESBLs)的发生率分别为54.7%和53.4%,多重耐药铜绿假单胞菌(MDRP)的发生率分别为11.9%和15.9%,多重耐药鲍曼不动杆菌(MDRA)的发生率分别为49.0%和64.8%,屎肠球菌和粪肠球菌对高水平庆大霉素耐药(HLGR)的发生率分别为62.6%和66.7%,对碳青霉烯类不敏感的发生率分别为2.1%和4.6%。高水平庆大霉素耐药(HLGR)肠球菌的发生率分别为62.6%和66.7%,碳青霉烯类不敏感肠杆菌的发生率分别为2.1%和4.6%。结论医院获得性血流感染病原菌主要为革兰阴性杆菌(以大肠埃希菌和肺炎克雷伯菌为主),替加环素和碳青霉烯类药物对其敏感率较高;革兰阳性球菌中分离率最高的为金黄色葡萄球菌、其次为屎肠球菌,替加环素、利奈唑胺、万古霉素和替考拉宁对其敏感率较高。多重耐药菌中MDRA、HLGR、MDRP以及碳青霉烯类不敏感肠杆菌科细菌的发生率分别升高了:15.8%、4.1%、4.0%和2.5%,应引起临床的关注。     

SEANIR监测中国15所教学医院不发酵糖革兰阴性杆菌对13种抗菌药物的药敏试验

目的分析SEANIR监测2008年中国15所教学医院医院获得性不发酵糖革兰阴性杆菌对抗菌药物的敏感性,并评价帕尼培南体外药敏试验方法。方法收集2008年分离自中国15所教学医院医院获得性感染患者的非重复鲍曼不动杆菌349株、铜绿假单胞菌359株、嗜麦芽窄食单胞菌145株和洋葱伯克霍尔德菌100株,用琼脂稀释法测定13种抗菌药物的MIC,对比MH培养基和1:40 MH培养基对帕尼培南药敏试验结果的影响。结果鲍曼不动杆菌对碳青霉烯类抗生素的敏感率仅为51.6%～63.7%;多黏菌素B和米诺环素对鲍曼不动杆菌的体外抑菌活性最强,且对亚胺培南耐药鲍曼不动杆菌仍具有较高的抑菌率(分别98.1%和72.8%)。多黏菌素B和阿米卡星对铜绿假单胞菌的抑菌率最高(分别为96.1%和83.3%),其次为用1:40 MH培养基测定帕尼培南、哌拉西林-他唑巴坦和美罗培南的抑菌率(72.4%～77.2%)。嗜麦芽窄食单胞菌和洋葱伯克霍尔德菌对米诺环素和甲氧苄啶-磺胺甲噁唑均较敏感(敏感率为78.6%～98.0%)。结论多黏菌素B对鲍曼不动杆菌和铜绿假单胞菌,米诺环素对鲍曼不动杆菌、嗜麦芽窄食单胞菌和洋葱伯克霍尔德菌,具有较强的体外抗菌活性。帕尼培南的体外药敏试验,鲍曼不动杆菌应采用MH培养基测定,铜绿假单胞菌应采用1:40 MH培养基测定,其抗菌作用与亚胺培南较为接近。     

Development of in vitro antimicrobial resistance in bacteria exposed to residue level exposures of antimicrobial drugs, pesticides and veterinary drugs

Ten ppb or less of antibacterial drugs, pesticides and veterinary drugs could increase antibacterial resistance in bacteria. The minimum inhibitory concentration (MIC) was the indicator of resistance and Staphylococcus aureus ATCC 9144 the indicator organism. Seventeen compounds used in human, veterinary medicine, crop production, and found in the environment, were studied singly, and as combinations. Single compounds decreased MIC values in 5.3% of possibilities; showed no changes in 74.4% of values; increased values in 21.8%; 16.5% of MICs increased 4- to 8-fold; 4.7% of changes were >8-fold. For two-compound mixtures 5.1% of MICs showed no changes; 34.3% increased 4-8 times; 60.6% increased >8-fold. For six-compound combinations: 5.9% of MICs showed no changes; 15.6% increased 4- to 8-fold; 78.5% increased >8-fold.