革兰阴性杆菌对亚胺培南耐药率的变迁

目的调查革兰阴性杆菌对亚胺培南的耐药率变化。方法收集2003年10月-2006年6月从住院患者各种临床标本中分离的革兰阴性杆菌,使用VITEK-32全自动微生物分析仪进行菌种的鉴定和药敏试验,对结果进行回顾性调查。结果共分离出革兰阴性杆菌2045株,35个细菌种,肠杆菌科细菌912株,占44.6%;非发酵菌1120株,占54.8%;分离率前5位的病原菌分别是铜绿假单胞菌、大肠埃希菌、鲍氏不动杆菌、肺炎克雷伯菌和洋葱伯克霍尔德菌;肠杆菌科细菌对亚胺培南的耐药率非常低,除弗氏柠檬酸杆菌外,其他肠杆菌科细菌对亚胺培南的耐药率均<1.0%;嗜麦芽寡养单胞菌、洋葱伯克霍尔德菌、脑膜脓毒金黄杆菌、铜绿假单胞菌和鲍氏不动杆菌对亚胺培南的耐药率分别为100.0%、98.6%、98.3%、22.3%和20.6%。结论临床分离的革兰阴性杆菌以非发酵菌为主,亚胺培南对肠杆菌科细菌具有非常强的体外抗菌活性,对非发酵菌的体外抗菌活性较差,铜绿假单胞菌和鲍氏不动杆菌对亚胺培南的耐药率呈上升趋势。

Vicissitudes of Antimicrobial Resistance to Imipenem in Gram-negative Bacilli

OBJECTIVE To investigate 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 hosptial from Oct 2003 to Jun 2006.The identification and antimicrobiol susceptiblity test were determined by VITEK-AMS Full Automated Microbiology Analyzer.RESULTS A total of 2045 strains of Gram-negative bacilli were isolated,including 35 species.From them 912 isolates of Enterobacteriaceae and 1120 isolates of non-fermenters accounted for 44.6% and 54.8%,respectively.The most predominant pathogens were Pseudomonas aeruginosa(21.1%),Escherichia coli(20.4%),Acinetobacter baumannii(14.2%),Klebsiella pneumoniae(9.4%),and Burkholderia cepacia(7.9%).The resistance rate of Enterobacteriaceae to imipenem was very low.The rates of Stenotrophomonas maltophilia,B.cepacia,Chryseobacterium meningosepticum,P.aeruginosa and A.baumannii to imipenem were 100.0%,98.6%,98.3%,22.3% and 20.6%.CONCLUSIONS Non-fermenters are predominant pathogens.Imipenem has high antimicrobial activity to Enterobacteriaceae in vitro,but not to non-fermenters.The resistance rates of P.aeruginosa and A.baumannii to imipenem increase gradually.