常见非发酵菌的耐药性分析

目的 了解常见非发酵菌的临床分布及耐药情况，指导临床合理使用抗菌药物。方法 2003年1月～2004年12月临床分离的铜绿假单胞菌281株、不动杆菌属190株及嗜麦芽窄食单胞菌63株，用Kirby—Bauer法进行药敏试验。结果 591株非发酵菌中以铜绿假单胞菌（47．5％）、不动杆菌属（32．1％）及嗜麦芽窄食单胞菌（10．7％）为主；主要分布于痰液（62．4％）、皮肤软组织创面分泌物（22．7％）中；耐药性分析显示铜绿假单胞菌对亚胺培南的敏感性最高（92．9％），其它依次为头孢他啶（78．3％）、环丙沙星（78．1％）、头孢吡肟（74．4％）、阿米卡星（70．5％）、哌拉西林-他唑巴坦（70．1％）、头孢哌酮-巴坦（67．9％）、哌拉西林（60．3％）、氨曲南（57．5％）、头孢哌酮（57．1％）、替卡西林-克拉维酸（55．7％）；不动杆菌属对亚胺培南的敏感性也最高（95．7％），其它依次为头孢哌酮-舒巴坦（66．7％）、头孢吡肟（59．3％）、替卡西林-克拉维酸（57．4％）、阿米卡星（55．0％）、哌拉西林-他唑巴坦（51．6％）；嗜麦芽窄食单胞菌对头孢哌酮-舒巴坦的敏感性最高（75．6％），其它依次为头孢他啶（75．5％）、复方磺胺甲嗯唑（74．5％）、替卡西林-克拉维酸（73．7％）、环丙沙星（69．8％）、头孢吡肟（63．4％）、哌拉西林-他唑巴坦（56．8％），对包括亚胺培南在内的其它常用抗菌药物均高度耐药。结论 细菌耐药有一定的地区性，定期对本地区细菌耐药性进行监测，对合理使用抗菌药物、减少耐药菌株的产生和流行有重要的临床指导价值。

Surveillance of bacterial resistance among non-fermentative bacilli

Objective To investigate the distribution and susceptibility of common non-fermentative bacilli from 2003 to 2004 in Tongling area for the rational use of antibiotics.Methods Antimicrobial susceptibility tests were tested by Kirby-Bauer method. Results Of 591 non-ferrmentative bacilli,281(47.5%) were P.aeruginosa;190(32.1%) were Acinetobacter spp.;63(10.7%) were S.maltophilia. Most of them were from sputum,skin and soft tissue exudate. The antibacterial activity of antimicrobial agents tested against P.aeruginosa were imipenem(92.9%),ceftazidime(78.3%),ciprofloxacin(78.1%),cefepime(74.4%), amikacin(70.5%),piperacillin-tazobactam(70.1%),cefoperazone-sulbactam(67.9%),piperacillin(60.3%),aztreonam(57.5%),cefoperazone(57.1%),ticarcillin-clavulanate(55.7%); while the activity against acinetobacter spp. were imipenem(95.7%),cefoperazone-sulbactam(66.7%),cefepime(59.3%),ticarcillin-clavulanate(57.4%),amikacin(55.0%),piperacllin-tazobactam(51.6%), and the activity against S.maltopbilia. were cefoperazone-sulbactam(75.6%), ceftazidime(75.5%),TMP-SMZ(74.5%),cefepime(59.3%),ticarcillin-clavlanate(57.4%),amikacin(55.0%),piperacillin-tazobactam(53.6%).The resistance rates to imipenem and other antimicrobial agents were much higher.Conclusions Bacterial resistance pattern are different in different regions.Surveillance of bacterial resistance is of great importance to both rational use of antibiotics and reducing the emergence of resistant strains.