奇异变形菌医院感染的耐药性变迁及临床对策

目的 分析临床分离的奇异变形菌的耐药性及其变迁,为临床合理用药提供依据.方法 对医院2008年1月-2010年12月住院患者各种标本中分离到的奇异变形菌385株,采用17种抗菌药物进行药敏试验；并比较3年的变迁情况.结果 分离到的奇异变形菌对亚胺培南/西司他丁的敏感率最高为100.0％,对美罗培南、哌拉西林/他巴唑、氨曲南、头孢曲松、头孢匹美、头孢他啶、妥布霉素的敏感率均＞90.0％；对呋喃妥因、磺胺甲噁唑/甲氧苄啶的耐药率均＞50.0％,头孢哌酮/舒巴坦为0.3％,对氨苄西林/舒巴坦、环丙沙星、左氧氟沙星耐药率呈升高趋势.结论 医院感染奇异变形菌分离率较高,对多种抗菌药物具有较高敏感性,但对某些抗菌药物耐药率呈上升趋势,应加强监测,根据药敏试验合理选用抗菌药物.

Change of drug resistance of Proteus mirabiliscausing nosocomial infections and clinical strategies

OBJECTIVE To analyze the change in antibiotic resistance of clinical isolates of Proteus mirabilis so as to provide basis for clinical reasonable use of antibiotics.METHODS A total of 385 P.mirabilis strains isolated from various clinical specimens from Jan 2008 to Dec 2010 were collected.Drug susceptibility testing was performed for 17 antimicrobial agents;the changes of the drug resistance during the 3 years were compared.RESULTS Of the P.mirabilis isolated,the susceptibility rate to imipenem/cilastatin was the highest(100.0%),the drug susceptibility rates to meropenem,piperacillin / methimazole,aztreonam,ceftriaxone,cephalosporin,ceftazidime,and tobramycin were above 90.0%;the drug resistance rates to nitrofurantoin and sulfamethoxazole / trimethoprim were above 50.0%,and the resistance rate to cefoperazone /sulbactam was 0.3%,the resistance rates to ampicillin/sulbactam,ciprofloxacin,and levofloxacin kept an increasing upward tendency.CONCLUSION The isolation rate of P.mirabilis is high,the susceptibility is high to many antimicrobial agents,but the drug resistance rates to some antibacterial agents are on the rise;it is necessary to strengthen the monitoring and reasonably use of antibiotics on the basis of drug susceptibility testing.