High efficacy of clofazimine and its synergistic effect with amikacin against rapidly growing mycobacteria

The aim of this study was to determine whether clofazimine, dapsone and cycloserine may be suitable antimicrobial agents for the treatment of infections due to rapidly growing mycobacteria (RGM). The antimicrobial activity of the three drugs against 117 Mycobacterium abscessus isolates, 48 Mycobacterium fortuitum isolates and 20 Mycobacterium chelonae isolates was evaluated based on their broth microdilution minimal inhibitory concentrations (MICs) against the isolates. Clofazimine was highly efficacious against these RGM. The vast majority of M. abscessus, M. fortuitum and M. chelonae isolates (99.1%, 91.7% and 100%, respectively) had clofazimine MICs of ≤1 mg/L. MIC₅₀ values (MIC for 50% of the organisms) of clofazimine against the isolates ranged from 0.25 mg/L to 0.5 mg/L and MIC₉₀ values (MIC for 90% of the organisms) ranged from 0.5 mg/L to 1.0 mg/L. Cycloserine and dapsone had little or no activity against the isolates. The effects of combined application of clofazimine and amikacin on 40 M. abscessus isolates, 48 M. fortuitum isolates and 20 M. chelonae isolates were evaluated. Addition of 0.25× MIC of amikacin for the isolates to clofazimine reduced clofazimine MICs in all of the M. abscessus and M. chelonae isolates and in 48% of the M. fortuitum isolates tested. Clofazimine, either alone or combined with amikacin, may serve as a promising drug for the treatment of RGM infections.     

Genotyping and in vitro antifungal susceptibility of Neoscytalidium dimidiatum isolates from different origins

This study evaluated the genetic variability and in vitro susceptibility patterns of isolates of Neoscytalidium dimidiatum and Scytalidium hyalinum from different geographical origins. Partial sequences of four loci (the ITS region and D1/D2 domains of the 28S rRNA gene and the tubulin and chitin synthase genes) were analysed. Among a total of 1970 bp sequenced in 24 isolates, 7 polymorphic positions (0.36%) were detected, representing five different sequence types (ST1–ST5), from which two (ST2 and ST3) were detected exclusively in isolates from plants, two (ST1 and ST5) were found only in clinical isolates and one (ST4) was observed in isolates from humans and from a mango tree. We propose subordinating S. hyalinum as a variety of N. dimidiatum. Amphotericin B was the most active drug, but low minimum inhibitory concentrations were also detected for voriconazole, terbinafine and anidulafungin.     

2014—2018年解放军第三一六医院妊娠期女性人型支原体和解脲支原体感染状况及耐药性分析

目的 分析2014-2018年解放军第三一六医院妊娠期女性人型支原体和解脲支原体感染状况及耐药性。方法 采用回顾性分析的方法,对2014年1月-2018年12月解放军三一六医院的1 171例妊娠期女性泌尿生殖道支原体感染状况及耐药情况进行分析。结果 1 171例妊娠期女性中,644例感染了解脲支原体和/或人型支原体,其中1人感染了人型支原体,590例感染了解脲支原体,53例共同感染了两种支原体。解脲支原体在17~20岁年龄段感染率最高,解脲支原体和人型支原体双阳性在41~50年龄段感染率最高。解脲支原体和/或人型支原体对喹诺酮类抗生素、阿奇霉素和红霉素的敏感性较低,对交沙霉素、克拉霉素、美满霉素、强力霉素和四环素的敏感性较高。结论 妊娠期女性泌尿生殖道支原体的感染率高,耐药严重,一定要根据培养鉴定和药敏试验选用敏感抗生素进行治疗。     

2013-2015年南通市第一人民医院儿童肺炎支原体感染病原菌的分布及耐药性分析

目的 调查2013-2015年南通市第一人民医院儿童肺炎支原体感染病原菌的分布及其耐药性.方法 选择2013年1月-2015年12月南通市第一人民医院儿科住院患儿950例,分析患儿的年龄、性别、疾病类型、季节分布,肺炎支原体对常用抗菌药物的耐药性及基因突变情况.结果 950例患儿送检样本中检测出120例阳性肺炎支原体,检出率为12.63%.其中0~6个月婴儿的肺炎支原体阳性检出率最低,3~14岁患儿的检出率最高;55例男患儿检测出阳性肺炎支原体,检出率为10.19%,65例女患儿检测出阳性肺炎支原体,检出率为15.85%;上呼吸道感染患儿阳性检出率为20.00%,下呼吸道感染患儿阳性检出率为10.97%;夏季患儿出现肺炎支原体感染的阳性检出率为17.52%,高于春、秋、冬季;肺炎支原体对吉他霉素、氧氟沙星、克林霉素、加替沙星、左氧氟沙星及多西环素敏感率较高,对其他抗菌药物的敏感率较低;120株标本中耐药组有34株,非耐药组有86株,其中耐药组有21株发生基因突变,非耐药组有10株发生基因突变,基因突变率显著低于耐药组.结论 南通市第一人民医院儿童肺炎支原体感染多发生在3~14岁上呼吸道感染的儿童,夏季发生率较高,临床上应根据致病菌株及耐药情况选择针对性抗菌药物,避免抗生素的滥用.     

2014-2015年西安市胸科医院结核分枝杆菌耐药性分析

目的 回顾性分析西安市胸科医院2014—2015年结核分枝杆菌的耐药情况,为本地区结核病的诊断、治疗以及预防提供参考.方法 收集西安市胸科医院2014—2015年门诊、住院患者结核分枝杆菌阳性菌株2583株,采用比例法对链霉素、异烟肼、利福平、乙胺丁醇、丙硫异烟胺、卷曲霉素、莫西沙星、利福喷丁、阿米卡星、对氨基水杨酸钠、左氧氟沙星共11种抗结核药物的耐药性进行测定.结果 共分离出2583株结核分枝杆菌,其中耐多药、广泛耐药、一线4种全耐药、二线7种全耐药、11种药物全耐药菌株分别为258、139、116、17、16株,耐药率分别为9.99%、5.38%、4.49%、0.66%、0.62%.对11种抗结核药物单一耐药率,由高到低分别为:异烟肼(23.96%)、链霉素(21.76%)、利福喷丁(14.83%)、利福平(14.05%)、左氧氟沙星(10.69%)、乙胺丁醇(9.33%)、莫西沙星(6.93%)、对氨基水杨酸钠(5.81%)、卷曲霉素(3.29%)、阿米卡星(2.09%)、丙硫异烟胺(1.55%).耐多药菌株对利福喷丁和左氧氟沙星的耐药率较高,分别为87.98%、53.88%.对利福喷丁+左氧氟沙星、莫西沙星+利福喷丁组合的耐药率分别高达51.94%、39.92%.广泛耐药菌株对对氨基水杨酸钠的耐药率最高,为32.37%.结论 2014—2015年西安市胸科医院抗结核病药物单一耐药率虽然呈下降趋势,但耐多药、广泛耐药和全耐药菌株的出现和增加提示还需要更加严格的执行结核病防控策略,防止各种耐药菌株的产生、增加和传播.     

2013—2015年西安市胸科医院结核分枝杆菌的耐药性分析

目的了解西安市胸科医院结核分枝杆菌的耐药情况,为临床医生调整治疗方案和流行病学调查提供依据。方法选取2013年1月—2015年11月西安市胸科医院结核分枝杆菌感染的住院患者392例,对分离出的病原菌的耐药性进行分析。结果菌株来源于132例初治患者和260例复治患者,其中男性患者多于女性患者,年龄段主要集中在36~55岁。初治耐药率为22.5%,获得性耐药率为41.2%;链霉素的耐药率最高,为23.7%,乙胺丁醇的耐药率最低,为13.3%;单一耐药菌株有60株,耐药率为15.4%;多耐药菌株有37株,耐药率为9.4%;耐多药的菌株有52株,耐药率为13.2%;有27株全耐药,耐药率为6.9%。结论西安市胸科医院结核分枝杆菌的耐药状况仍处较高水平,应做好结核分枝杆菌的培养和药敏试验,并根据药敏实验结果合理制定或调整治疗方案。     

Investigation of the prevalence of tetQ, tetX and tetX1 genes in Bacteroides strains with elevated tigecycline minimum inhibitory concentrations

In this study, the antibiotic susceptibilities to tigecycline and tetracycline of 35 selected Bacteroides fragilis group strains were determined by Etest, and the presence of tetQ, tetX, tetX1 and ermF genes was investigated by polymerase chain reaction (PCR). tetQ was detected in all 12 B. fragilis group isolates (100%) exhibiting elevated tigecycline minimum inhibitory concentrations (MICs) (≥8 μg/mL) as well as the 8 strains (100%) with a tigecycline MIC of 4 μg/mL, whilst tetX and tetX1 were present in 15% and 75% of these strains, respectively. All of these strains were fully resistant to tetracycline (MIC ≥ 16 μg/mL). On the other hand, amongst the group of strains with tigecycline MICs < 4 μg/mL (15 isolates), tetQ, tetX and tetX1 were found less frequently (73.3%, 13.3% and 46.7%, respectively). All but two strains harbouring the tetQ gene in this group were non-susceptible to tetracycline, with a MIC > 4 μg/mL. These data suggest that in most cases tigecycline overcomes the tetracycline resistance mechanisms frequently observed in Bacteroides strains. However, the presence of tetX and tetX1 genes in some of the strains exhibiting elevated MICs for tigecycline draws attention to the possible development and spread of resistance to this antibiotic agent amongst Bacteroides strains. The common occurrence of ermF, tetX, tetX1 and tetQ genes together predicted the presence of the CTnDOT-like Bacteroides conjugative transposon in this collection of Bacteroides strains.     

碳青酶烯类耐药肺炎克雷伯菌耐药基因检测及同源性分析

目的 探讨浙江省台州医院分离的碳青霉烯类耐药肺炎克雷伯菌（carbapenem-resistant Klebsiella pneumonia,CRKP）的耐药基因分型,并进行同源性分析。方法 收集浙江省台州医院2017年1月-2017年11月临床分离非重复的41株CRKP,用VITEK-compact2全自动微生物分析仪进行鉴定及药敏试验,质谱仪VITEK MS和纸片扩散法（K-B法）分别对鉴定、药敏进行复核;采用表型筛选试验对试验菌进行产A、B类碳青霉烯酶筛选;PCR检测耐药基因型;目的产物经基因测序和BLAST网上比对确定其基因型;脉冲场凝胶电泳（pulsed field gel electrophoresis,PFGE）分析41株菌株同源性。结果 表型筛选试验提示41株CRKP均产碳青霉烯酶;检出bla_KPC、bla_IMP、bla_NDM基因阳性率分别为95.12%（39/41）,4.88%（2/41）,2.44%（1/41）,未检测到bla_SIM、bla_SPM、bla_VIM、bla_GIM基因;测序结果bla_KPC、bla_NDM、bla_IMP基因型别为bla_KPC-2、bla_NDM-1、bla_IMP-4;PFGE结果可分为A~N共14个谱型,以A型41.46%（17/41）、B型21.95%（9/41）、C型9.76%（4/41）为主,A型主要分布于神经外科,B型、C型主要分布于重症医学科。结论 浙江省台州医院CRKP耐药基因型以bla_KPC-2为主,且存在克隆株传播。医院感染控制部门及临床各科室应引起重视,采取有效措施,控制耐药株的传播。     

Detection of point mutations associated with antibiotic resistance in Pseudomonas aeruginosa

Excessive use of broad-spectrum antibiotics in hospitals has led to the emergence of highly resistant strains of Pseudomonas aeruginosa. To reduce the selection pressure for resistance, it is important to determine the antibiotic susceptibility pattern of bacteria so that hospital patients can be treated with more narrow-spectrum and target-specific antibiotics. This study describes the development of a technique for detecting point muations in the fluoroquinolone resistance-determining region of the gyrA and parC genes as well as the efflux regulatory genes mexR, mexZ and mexOZ that are associated with fluoroquinolone and aminoglycoside resistance. The assay is based on a short DNA sequencing method using multiplex-fast polymerase chain reaction (PCR) and Pyrosequencing™ for amplification and sequencing of the selected genes. Fifty-nine clinical isolates of P. aeruginosa were examined for mutations in the abovementioned genes. Mutations related to antibiotic resistance were detected in codons 83 and 87 of gyrA and codon 126 of the mexR regulatory gene. Results of this study suggest Pyrosequencing™ as a substitute for traditional methods as it provides a rapid and reliable technique for determining the antibiotic resistance pattern of a given bacterial strain in <1 h.     

Prevalence and characterization of the mechanisms of macrolide, lincosamide and streptogramin resistance in viridans group streptococci

The presence of erm genes conferring constitutive and inducible resistance, as well as that of the mefA gene conferring only constitutive resistance, was investigated using PCR in 70 erythromycin resistant (MIC≥1 mg/l) strains of viridans group streptococci (VGS) (18 Streptococcus mitis biotype 1, 16 S. mitis biotype 2, 15 S. oralis, 12 S. salivarius and nine S. sanguis) isolated from the oropharynx of healthy Greek children. All of the 56 isolates belonging to resistance phenotype M harbored the mefA gene. All of the 14 isolates constitutively resistant to macrolides and lincosamides (phenotype CR) harbored the ermB gene. Co-presence of both genes was not observed, whereas class A erm gene (previously known as ermTR) was not detected. Our results are consistent with a possible role of VGS as a reservoir of resistance genes now prevalent in pathogenic species of streptococci.     

Mycobacterium fortuitum Meningitis Associated with an Epidural Catheter: Case Report and a Review of the Literature

Mycobacterium fortuitum is a rapidly growing organism that has rarely been associated with meningitis. A patient developed M. fortuitum meningitis as the result of a permanent indwelling, contaminated, epidural catheter. Diagnosis and treatment of the disease are difficult in that clinical features may be indolent, and many antimicrobials with activity against M. fortuitum have minimal cerebrospinal fluid penetration. This patient was cured with an antibiotic regimen that consisted of doxycycline, ciprofloxacin, imipenem, and clarithromycin, and removal of the epidural catheter.     

Drug-resistant Streptococcus pneumoniae in the Lebanon: implications for presumptive therapy

A total of 50 consecutive clinical isolates of Streptococcus pneumoniae, collected between 1996 and 1998, were tested against six antimicrobial agents using the E-test. The percentages of fully resistant (R) and intermediately-R strains, respectively, were: benzyl penicillin 18 and 38%, amoxycillin-clavulanate 6 and 12%, cefuroxime 22 and 16%, ceftriaxone 2 and 16%, and clarithromycin 10%. Fully and or intermediately multidrug-resistance (two or more drugs) was seen in 44% of the isolates, 18% being fully resistant. The MIC breakpoint for cefaclor is not defined by the National Committee for Clinical Laboratory Standards (NCCLS) but MICs showed that: 76% of the isolates had an MIC of ≤8 mg/l, 4% had an MIC of 16 mg/l and 20% had an MIC of ≥32 mg/l. There was agreement between the E-test Pen MIC results and the 1 μg oxacillin (oxa) disk diffusion screen test for the 22 susceptible and the nine fully R strains but not for the 19 strains with Pen MICs between 0.1 and 1 mg/l; this shows the importance of MIC determination in such isolates. Penicillin and multiply antibiotic-resistant pneumococci are spreading in Lebanon, emphasizing the necessity to reconsider current treatment regimens in this country.     

Diospyrone, crassiflorone and plumbagin: three antimycobacterial and antigonorrhoeal naphthoquinones from two Diospyros spp.

The aim of this study was to evaluate the antimycobacterial and antigonorrhoeal activities of three naphthoquinones (diospyrone, crassiflorone and plumbagin) from Diospyros canaliculata and Diospyros crassiflora as well as the crude extracts from these plants. The agar disk diffusion assay, broth microdilution method, microplate Alamar blue assay (MABA) and radiometric respiratory technique using the BACTEC 460 TB system were used. Results of the antimycobacterial assays indicated that the minimal inhibitory concentrations (MICs) and minimal bactericidal concentrations ranged from 1.22 μg/mL to 39.06 μg/mL for Mycobacterium smegmatis and all studied Mycobacterium tuberculosis strains for the crude extract from D. crassiflora, diospyrone and crassiflorone. Results of the killing rate experiment revealed that a total inhibition effect on M. tuberculosis H37Rv strain was observed at Day 18 for D. crassiflora and Day 21 for the crude extract from D. canaliculata and diospyrone at 4× MIC as determined by MABA. Results of the antigonorrhoeal assay indicated that diospyrone was able to prevent the growth of all studied strains of Neisseria gonorrhoeae. The overall results of this work provide evidence that the studied plant extracts (diospyrone, crassiflorone and plumbagin) might be potential sources of new antimicrobial drugs against tuberculosis and gonorrhoea.     

Current treatment of atypical mycobacteriosis

Background: Atypical mycobacteria are a heterogeneous group of organisms that are of increasing importance because of the growing number of infections they cause. This rising rate of infection is due mainly to the increase in the number of susceptible (and especially immunosuppressed) patients. Objective: To revise the currently used treatment schemes of the most commonly isolated atypical mycobacteria. Methods: Literature review using reference books and PubMed with specific keywords for each mycobacteria. Results/conclusion: The first important step in the management of atypical mycobacteria is to recognize the true infections caused by these organisms. The treatment required varies according to species. Well-characterized combinations exist for most common isolates, with the use of first-line antituberculous drugs (isoniazid, rifampin, ethambutol), clarithromycin, aminoglycosides and/or quinolones for slowly growing species (Mycobacterium avium complex, Mycobacterium kansasii, Mycobacterium xenopi, Mycobacterium ulcerans, Mycobacterium marinum, Mycobacterium lentiflavum, Mycobacterium malmoense) and macrolides, quinolones, amikacin and other antibiotics for rapidly growing mycobacteria (Mycobacterium abscessus, Mycobacterium chelonae, Mycobacterium fortuitum). Surgical therapy is also important for some species (Mycobacterium ulcerans, Mycobacterium scrofulaceum) and for localized infections. The treatment of uncommon species is not well defined and is determined by the results of in vitro tests of individual strains. Because of the increasing number of resistant strains, new antibiotics need to be used for the treatment of these strains.     

2018—2020年郑州市第七人民医院血流感染分离菌的分布及耐药性分析

目的 了解血流感染分离菌的分布及耐药特征,为临床防治血流感染提供指导和依据。方法 收集2018年1月—2020年12月郑州市第七人民医院血培养分离的非重复菌株,采用WHONET5.6软件统计菌株的分布及耐药特征。结果 共分离546株菌株,革兰阴性菌302株（55.31%）,革兰阳性菌220株（40.29%）,真菌24株（4.40%）。前6位分离菌依次为凝固酶阴性葡萄球菌（CNS,23.44%）、大肠埃希菌（18.68%）、肺炎克雷伯菌（14.84%）、金黄色葡萄球菌（6.04%）、鲍曼不动杆菌（4.21%）和铜绿假单胞菌（3.85%）。大肠埃希菌对碳青霉烯类最敏感,肺炎克雷菌碳对美罗培南和亚胺培南的耐药率分别为30.86%和35.80%,鲍曼不动杆菌耐药较严重,耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）和耐甲氧西林金黄色葡萄球菌（MRSA）的检出率分别为72.66%、42.42%,未发现利奈唑胺和万古霉素耐药的葡萄球菌。结论 革兰阴性菌是医院血流感染的主要致病菌,细菌耐药情况复杂,临床要根据药敏结果合理选择抗菌药物。     

Another look at differences in the susceptibility of Escherichia coli and Klebsiella pneumoniae to cephalothin and cefazolin

The significance of in vitro susceptibility tests on Enterobacteriaceae to cephalothin and cefazolin has not been exactly defined in the guidelines of the National Committee for Clinical Laboratory Standards. In the hope of clarifying this confusion, we provide additional information from an ancillary study of the Taiwan Surveillance of Antimicrobial Resistance 1998 (TSAR I). There were 505 Escherichia coli and 227 Klebsiella pneumoniae isolates susceptible to cephalothin, reported by 42 participating hospitals. The susceptibility of these isolates were re-tested at the Microbial Infections Reference Laboratory using cefazolin, with the result that 72% of the 252 cephalothin-resistant E. coli isolates and 24% of the 41 cephalothin-resistant K. pneumoniae isolates were found to be susceptible to cefazolin. We further surveyed the availability of cephalothin and cefazolin in Pharmacy Departments; all of the TSAR I hospitals had cefazolin available in their pharmacies. The resistance rate of E. coli was significantly lower for 12 hospitals that had cefazolin in both pharmacy and laboratory compared with 11 hospitals that had cefazolin available in pharmacy but cephalothin in laboratory. In addition, for all the hospitals that had cephalothin available for clinical use, the resistance rate was twice as low in two hospitals reporting cefazolin susceptibility as in the seven hospitals reporting cephalothin susceptibility. Our findings suggest that inappropriate selection of cephalothin and cefazolin for susceptibility testing contribute to inaccurate indications of in vivo activity for first generation cephalosporins in the treatment of E. coli infections.     

Class 1 integrons in environmental and clinical isolates of Pseudomonas aeruginosa

The aims of this study were to ascertain the presence and spread of class 1 integrons amongst environmental and clinical isolates of Pseudomonas aeruginosa and to characterise their variable regions. A total of 76 isolates (56 clinical and 20 environmental) were studied. The presence of plasmids was explored, and polymerase chain reaction (PCR) was used for integron detection. All amplicons were sequenced. PCR detected class 1 integrons in 26 of the 56 clinical isolates; environmental isolates were integron-free. No plasmids were found, thus all the integrons found are possibly on the chromosome. Most isolates presented one amplicon, except PA110514 and PA116136, which showed two PCR products each. Variable regions revealed that 18 strains carried only one gene involved in aminoglycoside resistance, whereas in 3 strains gene cassettes were not found. The most prevalent cassettes amongst isolates were those encoding aminoglycoside adenyltransferase B (aadB). Several of the strains had acquired the same or a highly similar cassette array as those detected in geographically distant P. aeruginosa. This finding suggests that contact with bacterial reservoirs contributes to the evolution of this pathogen towards multiresistance. Empty structures found may represent a reservoir increasing the capacity to adapt to the environment. However, these integrons are not retained when the selective pressure disappears. It is hypothesised that integrons containing gene cassettes are crucial vehicles for the rapid horizontal transfer of resistance. If this is so, reduced use of antibiotics may lead to a significant decrease in the carriage of integrons amongst P. aeruginosa strains.     

多西环素配伍阿莫西林四联方案根除幽门螺旋杆菌的疗效观察

目的 观察不同药物四联方案根除幽门螺旋杆菌（Helicobacter pylori,Hp）的疗效。方法 选取初次和补救治疗的Hp感染患者各180例,单盲随机分成4组,分别为初治试验组（阿莫西林胶囊+多西环素胶囊）、初治对照组（阿莫西林胶囊+克拉霉素片）、补救治疗试验组（阿莫西林胶囊+多西环素胶囊）、补救治疗对照组（阿莫西林胶囊+左氧氟沙星片）,各组均联合埃索美拉唑肠溶片、胶体果胶铋胶囊,每天2次,疗程14 d。疗程结束4周后复查¹³C呼气试验,观察Hp根除率、不良反应、成本-效果比（cost-effectiveness ratio,C/E）,并做6,12个月随访,观察Hp复发率。结果 在Hp初治组中,试验组和对照组Hp根除率和复发率比较无统计学意义,但试验组C/E较低。在Hp补救治疗组中,试验组Hp根除率较高,疗效较好,与补救治疗对照组相比,差异有统计学意义（P<0.05）,C/E较低,复发率较低,差异无统计学意义。各组不良反应比较,初治试验组、补救治疗试验组、补救治疗对照组的不良反应发生率较低,与初治对照组相比差异有统计学意义（P<0.01）。结论 多西环素配伍阿莫西林四联方案根除Hp近远期疗效较好,成本较低。     

2017—2020年克拉玛依市中心医院抗菌药物使用强度与分离菌耐药性变化情况

目的 分析克拉玛依市中心医院2017—2020年住院患者常见分离菌分布及耐药率的变迁情况,为指导抗菌药物临床合理应用提供依据。方法 收集2017—2020年克拉玛依市中心医院住院患者抗菌药物使用情况及分离菌,分析主要分离菌对常见抗菌药物的耐药率变化趋势。结果 2017—2019克拉玛依市中心医院抗菌药物使用率和使用强度呈下降趋势,4年共有分离菌12 135株,其中革兰阳性菌2 567株,占21.15%;革兰阴性菌6 310株,占52.00%;真菌3 258株,占26.85%。居前5位的分离菌分别是白色假丝酵母菌（19.59%）、大肠埃希菌（16.84%）、肺炎克雷伯菌（13.33%）、鲍曼不动杆菌（8.71%）和铜绿假单胞菌（7.94%）。主要分离菌对常用抗菌药物耐药率总体呈下降趋势,肠杆菌科细菌对临床常用抗菌药物耐药性下降最明显。结论 克拉玛依市中心医院分离菌逐年增加,耐药率有下降趋势,抗菌药物临床应用基本合理,但需完善真菌检测能力。