重症监护病房革兰阴性菌耐药现状研究

目的：了解我院重症监护病房分离菌株对常用抗生素的耐药现状。方法：采用琼脂双倍稀释法测定从我院重症监护病房分离的230株革兰阴性菌的最低抑菌浓度（MIC），并采用抑制剂增强的纸片扩散法测定大肠埃希菌和肺炎克雷伯菌超广谱β－内酰胺酶（ESBLs)。结果：50株肺炎克雷伯菌和17株大肠埃希菌中ESBLs阳性率为62．1％。阴沟肠杆菌、产ESBLs的大肠埃希菌和肺炎克雷伯菌对三代头孢、庆大霉素、阿米卡星的耐药率≥50％。而对碳青霉烯类非常敏感。铜绿假单胞菌对各种抗菌药物均有一定的耐药性。嗜麦芽寡养单胞菌对碳青霉烯类耐药率达100％。结论：受试的230株革兰阴性菌对三代头孢、复合青霉素、氨基糖苷类和环丙沙星的总耐药率≥30％。CPZ／SB和头孢吡肟、碳青霉烯类耐药率较低。

Study on the resistance to antibiotics of the Gram (-) bacteria isolated from ICU

OBJECTIVE:To investigate the resistance of the bacteria isolated from ICU to commonly used antibiotics. METHOD:Using the method of agar dilution to measure the MIC of 230 Gram (-) bacteria isolated from ICU of our hospital, and using the method of inhibitor potential disk dilution to detect the extended spectrum beta-lactamases (ESBLs) produced by Escherichia Coli and Klebsiella pneumoniae. RESULTS:The ESBL positive rate in 50 strains of Escherichia Coli and 17 strains of Klebsiella pneumoniae is 62.1%. The resistant rates of Enterobacter cloacae, Escherichia Coli and Klebsiella pneumoniae which produce ESBLs to the third generation cephalosporins, gentamycins and amikacin are more than 50%, while those strains are sensitive to carbopenems. Most of Pseudomonas aeruginosa are resistant to all kinds of antibiotics. The resistant rate of Xanthomonas maltophilia to carbopenems is 100%. CONCLUSION:The total resistant rates of 230 strains to the third generation cephalosporins, complex penicillins, aminoglycosides and ciprofloxacin are more than 30%. The resistance to CPZ/SB, cefepime and carbopenems are lower.