196株阴沟肠杆菌对抗菌药物的敏感性分析

目的了解全身感染和尿液感染的阴沟肠杆菌对抗菌药物的敏感性,为临床提供治疗依据。方法采用微量稀释法对196株临床送检的血液、尿液及其他标本分离的阴沟肠杆菌进行药敏试验,测定其最低抑菌浓度值。结果阴沟肠杆菌对亚胺培南的敏感率为96.9%,对哌拉西林/他唑巴坦、左氧氟沙星、环丙沙星、庆大霉素、妥布霉素的敏感率为60%～80%,对头孢他啶、氨曲南、头孢曲松、哌拉西林的敏感率为40%～60%,对氨苄西林/舒巴坦的敏感率为14.3%,对氨苄西林和头孢唑啉的敏感率仅为3.6%和1.5%;分离自尿液的阴沟肠杆菌对氨苄西林/舒巴坦、头孢唑啉的敏感性高于血液分离菌,分离自尿液的阴沟肠杆菌对氨苄西林、头孢他啶、头孢曲松、环丙沙星、庆大霉素、亚胺培南、左氧氟沙星、氨曲南、哌拉西林、哌拉西林/他唑巴坦、妥布霉素的敏感性低于血液分离菌。结论阴沟肠杆菌对不同的抗菌药物的敏感性差异较大,治疗时应根据耐药特点及菌种间的耐药性差异选择相应的药物和方案,目前亚胺培南仍然是治疗阴沟肠杆菌感染的有效药物。

Susceptibility analysis of 196 strains Enterobacter cloacae

Objective To investigate the susceptibility of Enterobacter cloacae isolated from system and urine patients,and to provide reference for clinical therapy.Methods The susceptibility（MIC） of 196 Enterobacter cloacae strains from blood,urine and others were tested by broth microdilution test.Results The sensitive rate of ECL to Imipenem was about 96.9%.The sensitive rate of piperacillin/Tazobactam,ofloxacin,ciprofloxacin,gentamycin,tobramycin were about 60%-80%,The sensitive rate of ceftazidime,Azactam,ceftriaxone,piperacillin were about 40%-60%.The sensitive rate of ampicillin/sulbatam was 14.3%.The sensitive rate of ampicillin and cefazolin were only 3.6% and 1.5%.The susceptibility rate of Enterobacter cloacae isolated from urine was a little higher than the strains isolated from blood to ampicillin/Sulbatam,cefazolin.The susceptibility rate of Enterobacter cloacae isolated from urine was higher than the strains isolated from blood to ampicillin,ceftazidime,ceftiaxone,ciprofloxacin,gentamycin,imipenem,ofloxacin,azactam,piperacillin、piperacillin / Tazobactam,tobramycin.Conclusion The drug susceptibility of Enterobacter cloacae causing systemic and urine infection is different.The available therapy project should be selected based on the resistance character.At present,Imipenem is the active drug for treatment against the infection caused by Enterobacter cloacae.