主要革兰阴性杆菌对亚胺培南耐药率的变迁

目的 了解革兰阴性杆菌对亚胺培南的耐药率变化.方法 收集2006年1至2009年12月我院就诊患者的标本分离获得的革兰阴性杆菌,采用美国Dade MicroScan公司生产的AutoSCAN4半自动鉴定仪及配套的生化反应药敏板进行鉴定,药敏试验方法采用Mic法.结果 共分离革兰阴性杆菌4822株,116个种,肠杆菌科细菌3184株,占66.0%;非发酵菌1536株,占31.9%;分离率前5位的细菌分别是大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、阴沟肠杆菌和鲍曼不动杆菌.肠杆菌科细菌对亚胺培南的耐药率较低,近4年内耐药率变化不明显;非发酵菌对亚胺培南的耐药率比较高,呈上升趋势;嗜麦芽窄食单胞菌的耐药率达100%;铜绿假单胞菌和木糖氧化产碱杆菌耐药率明显上升.结论 肠杆菌科细菌和非发酵菌是临床分离的主要革兰阴性杆菌,肠杆菌科细菌对亚胺培南的耐药率较低,非发酵菌对亚胺培南的耐药率比较高,呈上升趋势.

Vicissitudes of antimicrobial resistance to imipenem in Gram-negative bacilli

Objective To understand the vicissitudes of antimicrobial resistance to imipenem in Gram-negative bacilli isolated from clinical specimens. Methods Gram-negative bacilli were isolated from various clinical specimens in our hospital from January 2006 to December 2009. Pathogens were identified by AutoSCAN4 ( Dade Microscan, USA) and identified tests. The Mic susceptibility test was used as drug resistance test. Results A total of 4822 strains of Gram-negative bacilli were isolated, including 116 species. From them 3184 isolates of Enterobacteriaceae and 1536 isolates of non-fermenters accounted for 66.0% and 31.9%, respectively. The most predominant pathogens were Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii.The resistance rate of Enterobacteriaceae to imipenem was very low and did not change in past four year. The resistance rate of non-fermenters Gram-negative bacilli showed high resistance rate and increase gradually. Conclusions Enterobacteriaceae and non-fermenters are predominant pathogens. The resistance rate of Enterobacteriaceae to imipenem is very low and non-fermenters shows high resistance rate and increase gradually.