1 595株革兰阴性杆菌对常用抗菌药物的耐药性分析

目的：了解浙江绍兴地区临床分离的主要革兰阴性病原菌的耐药情况。方法：采用Kirby-Bauer法对浙江省绍兴地区2002～2003年分离的1595株革兰阴性杆菌进行药物敏感试验。采用双纸片法检测上述菌株产生的超广谱β-内酰胺酶。结果：上述革兰阴性杆菌最为敏感的抗生素为碳青酶烯类抗生素亚胺培南(95．5％，965／1010)和美洛培南(94．6％，954／1008)，其次是派拉西彬他唑巴坦(93．8％，640／682)，敏感性最低的抗生素为头孢噻吩(15．8％，238／1508)。25．4％(40／157)和26．1％(41／157)的铜绿假单胞菌菌株对美洛培南和亚胺培南耐药。大肠埃希菌对环丙沙星的耐药率高达61．3％(410／669)。13．2％的大肠埃希菌(89／675)和18．4％的肺炎克雷伯菌(80／436)为超广谱β-内酰胺酶菌株(ESBLs)，但未发现铜绿假单胞菌和鲍氏不动杆菌有ESBLs菌株。结论：碳青酶烯类抗生素、派拉西林／他唑巴坦仍是目前细菌耐药性较低抗生素。但本地区耐碳青酶烯类抗生素的铜绿假单胞菌株，以及大肠埃希菌和肺炎克雷伯菌ESBl6菌株已较为常见。

Drug resistance analysis on 1 595 strains of gram-negative bacilli to clinical routing antibiotics

Objective:To understand drug resistance of dominant gram-negative pathogenic bacteria isolated from Shaoxing area in Zhejiang province Methods:Drug sensitivity test was performed to examine drug resistance of 1 595 strains of gram-negative bacilli isolated from Shaoxing area during the beginning of 2002 to the end of 2003 by Kirby-Bauer method Extended spectrum beta-lactamase produced by the microbes was detected by using double paper strip method Results:The most sensitive antibiotics tested for the gram-negative bacilli mentioned above was imipenem (95 5%, 965/1010) and meropenem (94 6%, 954/1008), which belonging to carbapenems, and then the piperacillin/tazobactam (93 8%, 640/682) Cephalothin was found to be the lowest sensitive antibiotic (15 8%, 238/1508) 25 4 % (40/157) and 26 1% (41/157) of the P aeruginosa strains showed resistance to imipenem and meropenem Resistant rate to ciprofloxacin of the E coli strains was as high as 61 3% (410/669) 13 2% of the E coli strains (89/675) and 18 4% of the K pneumoniae strains (80/436) were demonstrated to be ESBLs.But no ESBLs could be found in the strains of P aeruginosa and A baumannii Conclusion:Carbapenems and piperacillin/tazobactam remain to be the antibiotics with lower resistance currently However, the strains of P aeruginosa resistant to carbapenems and ESBLs in E coli and K pneumoniae become frequent in the local [