昆明地区甲型副伤寒沙门菌的耐药性分析

目的了解昆明地区甲型副伤寒沙门菌对几种临床常用抗菌药物的耐药现状,分析萘啶酸用于测试肠道外沙门菌感染分离株对氟喹诺酮敏感性减低的临床意义,为临床合理使用抗菌药物提供依据。方法从2002年1月至2005年6月门诊和住院患者血或骨髓标本中培养分离的532株甲型副伤寒沙门菌,对几种临床常用抗菌药物的敏感试验结果作为动态分析,并对其中273例住院患者的病历进行了抗菌药物运用及其疗效的回顾性分析。结果甲型副伤寒沙门菌对萘啶酸耐药率为98.5%;诺氟沙星18.6%;氨苄西林11.5%;复方新诺明8.5%;对头孢曲松、氯霉素、环丙沙星、左旋氧氟沙星敏感性为100%。273例住院患者治疗选用三代头胞(头孢曲松或头孢哌酮)45例;广谱青霉素(氨苄西林或替卡西林)+氟喹诺酮(环丙沙星或左旋氧氟沙星)25例;头孢三代+氟喹诺酮73例;单独使用左旋氧氟沙星130例。273例住院患者除外7例自动出院,其余均治愈出院。结论甲型副伤寒沙门菌感染治疗,推荐首选三代头孢菌素、左旋氧氟沙星;萘啶酸用于测试肠道外沙门菌感染分离株对氟喹诺酮敏感性减低临床意义值得商榷。

Drug resistant analyse of salmonella paratyphi A in KunMing territory

Objective To study the inrestigate antibiotic resistance patlerns of Salmonella paratyphi A to quinolones drug in KunMing for the guidance of rational use of antibiotic.Methods From Jan 2002 to Jun 2005,532 salmonella paratyphi A samples had been isolated and tested by K-B method from clinical samples.The antibiotic resistance was analyzed and studied retrospectively.Results The resistance rate of salmonella paratyphi A to Nalidixic acid,Norfloxacin,Ampicillin and Smz/Tmp are 98.5%, 18.6% ,11.5% and 8.5%.And the sensitive rate to Ceftriaxone,Chloramphenicol,Ciprofloxacin and Levofloxacin are 100% .Conclusions Patients infected with Salmonella paratyphi A should by treated by Ceftriaxone,Levofloxacin at first.We are not certain whether it is necessary to use Nalidixic acid to test the sensitivity of Levofloxacin and Ciprofloxain.