129株弗氏柠檬杆菌临床分离株的耐药性

探讨弗氏柠檬酸杆菌临床分离株对抗菌药物的体外敏感性.研究我院1998年 1月～ 2001年 6月从临床标本中分离出的 129株弗氏柠檬酸杆菌,测定其对17种抗菌药物的敏感性,分析药敏结果.从痰、尿、脓液、伤口分泌物、血、胆汁、胸水、腹水和静脉导管的临床标本中共分离出129株弗氏柠檬酸杆菌.这 129株对 17种抗菌药物的耐药率分别为亚胺培南7.75%,阿米卡星 14.72%,头孢吡肟 27.91%,哌拉西林 /三唑巴坦 34.89%,氨曲南46.51%,头孢噻肟 46.51%,头孢曲松 49.61%,头孢他啶 50.4%,环丙沙星 50.4%,妥布霉素53.49%,庆大霉素 60.46%,复方磺胺甲 唑 61.24%,头孢呋辛 69.77%,氨苄西林 /舒巴坦72.89%,哌拉西林 78.29%,头孢西丁 89.15%,头孢唑林 94.34%. 结论对我院弗氏柠檬酸杆菌临床分离株对亚胺培南和阿米卡星耐药率较低,但对包括第三代头孢菌素在内的其它抗菌药物的耐药率高,且存在多重耐药菌株,对其耐药性和耐药机制应加强监测和研究.

In vitro susceptibility to antimicrobial agents of Citrobacter Freundii:A study on 129 clinical isolates

To assay the in vitro antimicrobial susceptibility of clinical isolates of Citrobacter freundii,129 strains of C.freundii from clinical specimens were isolated and collected from Jan 1998 to Jun 2001 and were tested to 17 antimicrobial agents by the MicroScan R WalkAway R- 40,a commercial automatic system.A total of 129 strains of C.freundii were isolated from sputum,urine,blood,wound secretion,pus,bile,pleural fluid,ascitic fluid,and venous catheter.These isolates of C.freundii were most sensitive to imipenem and amikacin with the susceptible rate of 91.47% and 84.5% respectively,and relatively to cefepime,while less to piperacillin/tazobactam,the 3rd generation cephalosporins,aztreonam,tobramycin,gentamicin,ciprofloxacin,and co- SMZ,and highly resistant to the 1st and 2nd generation cephalosporins,cefoxitin,piperacillin, and ampicillin/sulbactam.According to susceptibility test,imipenem or amikacin may be a good choice for empiric chemotherapy for C.freundii infections.The resistance of C.freundii is significant,especially in MDR isolates.There was coexistent of multiplicate different mechanisms of resistance.