3年2436株临床分离革兰阴性杆菌对头孢吡肟耐药趋势观察

目的：调查我院1999－2001年间2436株革兰阴性杆菌分离株对第4代头孢菌素头孢吡肟的耐药状况，为临床合理用药提供依据。方法：用K－B法检测头孢吡肟对8种2436株临床分离菌的抑菌环，按1999年NCCLS判断标准得出耐药结果，并与其他3种第3代头孢菌素比较。结果：头孢吡 肟对ESBL阴性大肠杆菌和克雷伯菌属，肠杆菌属，枸橼酸杆菌属，变形杆菌，不动杆菌属，铜绿假单胞菌和嗜麦芽窄食单胞菌等临床主要分离革兰阴性杆菌耐药性变化不大，1999－2001年耐药率分别为20．6％，20．4％和28％，与第3代头孢菌素比较，头孢吡肟，头孢他啶，头孢噻肟，头孢曲松总的细菌耐药率分别为24．6％，26．3％，38．5％和37．0％。结论：头孢吡肟对临床分离的大部分革兰阴性杆菌具有良好的体外抗菌活性，尤其对易产Bush-I型头孢菌素的肠杆菌属的菌株及枸橼酸杆菌属的抗菌活性远优于其他第3代头孢菌素。

Drug Resistance Trend of Cefepime to 2436 Isolates of Clinical Gram-negative Bacterium in The Last Three Years

OBJECTIVE: To investigate the drug resistance of cefepime to 2436 clinical gram-negative bacterium during the last three years, to provide basis for clinical diagnosis and therapy. METHOD: According to NCCLS published in 1999, the diameters of inhibition zone of 2436 clinical isolates around antibiotic susceptibility test disks was computer filed and analyzed by the software of Whonet 5. Compared the result with the third generation cephalosporin. RESULTS: The drug resistance variation of cefepime was not too much, from 1999 to 2001 year the resistance was 20.6%, 20.4% and 28%. Compared with the third generation cephalosporin, the drug resistance of cefepime, ceftazidime ,cefotaxime and ceftriaxone were 24.6%, 26.3%, 38.5% and 37%. CONCLUSIONS: The cefepime was the most active agents against the clinical gram-negative bacterium, especially excelled to the third generation cephalosporin to enterobacter and citrobacter, which can produce Bush-I cephalosporinase.