摘要
目的了解湖北地区不动杆菌属耐药现状及变化趋势,并探讨不同来源菌株耐药率间的差别。方法采用纸片扩散法检测药物敏感度,协同法过筛试验检测金属β内酰胺酶(MBL)。结果2000-2004年分离的2 829株不动杆菌属的主要来源为痰。抗菌作用最强的抗菌药物为亚胺培南,其次是头孢哌酮-舒巴坦,ICU菌株的耐药性明显高于非ICU患者和门诊患者(P>0.05)。除第一代、第二代头孢菌素、头孢哌酮和氨曲南外,非ICU患者和门诊患者对其余抗菌药物耐药率均较低,分别在40%和20%以下。15种常用抗菌药物耐药率总体呈上升趋势,尤其细菌对头孢他啶、阿米卡星、环丙沙星等以往作用较好的药物的耐药率增高更为显著。从我院2004年1-9月分离的37株耐亚胺培南鲍曼不动杆菌中筛选出8株细菌产MBL。结论门诊患者、非ICU患者I、CU患者所分离的不动杆菌耐药率间存在差别,对临床经验用药具有一定指导意义。产MBL可能是湖北地区不动杆菌属耐亚胺培南的重要原因。
Objective To analyze the resistance pattern and trend in Acinetobacter strains isolated from 15 tertiary hospitals of Hubei province from 2000 through 2004, and study the difference in resistance rate of isolates from different wards. Methods The susceptibility was tested by K-B method. The synergetic screening test was applied to detect metallo-β-lactamases. Results The main source of 2 829 isolates was sputum, accounting for 74. 4%. Imipenem was the most active antibiotic tested, to which up to 90% to all isolates were susceptible, followed by cefoperazone-sulbactam. Isolates from ICU were more resistant to all antimicrobials than those from out-patients and non-ICU inpatients. The isolates from non-ICU inpatients and out-patients were less resistant to other antimicrobials but cefazolin, cefuroxime, cefoperazone and aztronam, with resistance rate of less than 40% and 20% respectively. The trend of the resistance to 15 commonly used antibiotics was going up in general, especial- ly ceftazidime, amikacin and ciprofloxacin. Eight metallo-β-lactamase-producing strains were screened out from 37 strains of Acinetobacter baumannii resistant to imipenenm, which were isolated from Tongji Hospital between January and September in 2004. Conclusions It is valuable for empiric antimicrobial therapy to analyze the differential resistance rate in Acinetobacter spp. isolates from out-patients, non-ICU inpatients and ICU patients. Production of metallo-β-lactamases may be one of the important reasons underlying the resistance of Acinetobacler spp. to imipenem in Hubei province.
出处
《中国抗感染化疗杂志》
CAS
2005年第6期342-345,共4页
Chinese Journal of Infection and Chemotherapy
关键词
不动杆菌属
耐药性
金属Β内酰胺酶
Acinetobacter spp
Antibiotic resistance
Metallo-β-lactamase
