目的:了解六安市2008年临床分离的革兰阴性菌耐药情况。方法:采用国际标准平皿琼脂对倍稀释法,对2008年9月从六安市3家医院临床分离的非重复的102株革兰阴性菌进行体外药敏试验,测定细菌的最低抑菌浓度,并按照美国临床实验室标准化研究所2008年的标准,计算细菌对抗菌药物的敏感率、中介率和耐药率。结果:102株革兰阴性菌中,大肠埃希菌27株,鲍曼不动杆菌25株,铜绿假单胞菌23株,肺炎克雷伯菌18株,嗜麦芽窄食单胞菌7株,其他2株;对碳青霉烯类抗菌药物最敏感,对哌拉西林/三唑巴坦(73.5%)也较敏感,其次较敏感的药物为阿米卡星(67.6%)、磷霉素(62.7%);耐药性高的药物依次是氨苄西林(96.1%)、头孢西丁(83.3%)、氨曲南(81.4%),对头孢哌酮/舒巴坦(51.0%)及头孢吡肟也有明显耐药性(39.4%)。结论:临床上应遵循《抗菌药物临床应用指导原则》合理应用抗菌药物,有指征地使用抗菌药物并应加强细菌耐药性监测,以防止细菌耐药性的蔓延。
Objective:To investigate the surveillance data of bacterial resistance in Lu'an city hospitals in 2008. Methods:Bacterial susceptibility experiments were performed on 102 samples clinically collected from 3 hospitals in Lu' an city, using routine custom dilution MIC method according to the CLSI ( 2008 ) guidelines ; the resistance, intermediate and susceptible rates of the bacteria to antimicrobial agents were measured. Results: Among the 102 bacteria samples, Escherichia coli accounted for 27, Acinetobacter baumannii 25 ,Pseudomonas aeruginosa 23, Klebsiella 18, Stenotrophomonas maltophilia 7 and others 2. Carbapenems were the most effective antimicrobial agents against Gram-negative bacilli, and other effective ones were piperaeillin-tazobactam (73.5%), amikacin (67.6%) and fosfomycin ( 62.7% ). Gram-negative bacilli showed high resistance to ampieillin ( 96.1% ), cefoxitin ( 83.3% ) and aztreonam (81.4%), and were also noticeably resistant to cefoperazone/sulbactam (51.0%) and cefepime (39.4%). Conclusions: We should administer antimicrobial drugs according to the "Guiding principles for the clinical use of antibacterial drugs" , and rationally choose antimicrobial agents in treatment of bacterial infections to control the bacterial resistance rates.