1980—1983年重庆地区常见致病菌耐药变迁及临床疗效观察

本文报告重庆地区1980～1983年8种常见致病菌对26种抗菌药物敏感度测定结果,并与本地区60和70年代结果作了比较。对同期174例细菌性感染疗效进行了分析。结果表明,对金黄色葡萄球菌所致严重感染的治疗,以耐酶半合成青霉素为首选,青霉素G仍可用于敏感菌株所致感染;肠杆菌科细菌所致严重感染以第三代头孢菌素或联合丁胺卡那霉素治疗为主;氯霉素和复方SMZ仍可作为治疗伤寒的首选药物;细菌性痢疾急性期患者可用复方SMZ治疗,慢性期可选用丁胺卡那霉素或氨苄青霉素;绿脓杆菌所致严重感染以丁胺卡那霉素和头孢氧哌羟苯唑治疗为宜。

STUDIES ON THE CHANGE OF RESISTANCE OF COMMON BACTERIAL PATHOGENS AND CLINICAL OBSERVATION IN CHONGQING DURING 1980-1983

This paper reports the results of 26 antimicrobial agents against 353 strains of clinical isolates, including S, aureus, E. coli, E. aerogenes, Klebsiella, Proteus, Salmonella, Shigella and Ps. aeruginosa, etc, by tube double dilution method in Chongqing during 1980 - 1983, and compates with the results of 1960s and 1970s. Clinical observations on the treatment of infections caused by these organisms are also reported.The results indicated that 6 cephalosporins, vancomycin, oxacillin, cloxacillin and ampicillin had marked activity against S. aureus, the susceptibility rates were high, varying from 96-100%; Penicillin.G retained its antistaphylococcal activity, the susceptibility rate was 90,2%. There was a decreasing trend of sensitivity to erythromycin and gentatnicin. Therefore penicillinasc-resistant semisynthetic penicillin is the drug of first choice in infections due to S. sureus. During recent years the resistance rates of Enterobacteriaceae against commonly used antibiotics were increased. The thrid generation cephalosporins and amikacin are the drugs of choice in severe infections caused by these Gram-negative rods. Chloramphmicol and SMZ/TMP were still active against S. typhi, and the sensitivity to chloramphenicol has not changed during the last 24 years, thus they are the drugs of choice in typhoid fever. SMZ/TMP were active against all shigellae strains, and the susceptibility rates of geatamtcio, kanamycin, amikacin and cephalosporins varied from 98-100%. SMZ/TMP are preferred in acute bacillary dysentery, while amikaoin and ampicillin are the drugs of choice in chronic bacillary dysentery. Resistance rates of Ps. aeruginosa against most antibiotics are quite high, and this paper demonstrated that the activity of amikacin was the highest. The results in the treatment of infections caused by these commonly encountered pathogens generally correlated fairly well with the in vitro sensitivty test.