中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2008年
6期
623-627
,共5页
王辉%陈民钧%倪语星%孔庆莲%梅亚宁%俞云松%廖康%孙自镛%胡志东%褚云卓%黄心宏%于秀娟%赵旺盛%徐英春%谢秀丽
王輝%陳民鈞%倪語星%孔慶蓮%梅亞寧%俞雲鬆%廖康%孫自鏞%鬍誌東%褚雲卓%黃心宏%于秀娟%趙旺盛%徐英春%謝秀麗
왕휘%진민균%예어성%공경련%매아저%유운송%료강%손자용%호지동%저운탁%황심굉%우수연%조왕성%서영춘%사수려
革兰阴性菌%抗药性,细菌%药物监测%微生物敏感性试验%医院,教学
革蘭陰性菌%抗藥性,細菌%藥物鑑測%微生物敏感性試驗%醫院,教學
혁란음성균%항약성,세균%약물감측%미생물민감성시험%의원,교학
gram-Negative bacteria%Drug resistance,bacterial%Drug monitoring%Microbial sensitivity tests%Hospitals,teaching
目的 监测2006年我国革兰阴性杆菌的耐药性.方法 收集2006年9-12月10家教学医院987株非重复的革兰阴性杆菌.菌株经中心实验室复核后,采用琼脂稀释法测定美罗培南等广谱抗菌药物的最低抑菌浓度(MICs).结果 10种抗菌药物对于629株肠杆菌科细菌的抗菌活性的敏感率由大至小依次为:美罗培南(敏感率99.8%)、业胺培南(敏感率99.5%)、哌拉西林/三唑巴坦(91.3%)、阿米卡星(89.3%)、头孢吡肟(83.8%)、头孢哌酮/舒巴坦(79.7%)、头孢他啶(74.7%)、头孢噻肟(57.7%)、头孢曲松(56.6%)、环丙沙星(53.6%).大肠埃希菌中超广谱β内酰胺酶(ESBL)的发生率为59.0%,高于肺炎克雷伯菌(33.0%)和奇异变形杆菌(8.0%).对于大肠埃希菌和肺炎克雷伯菌,抗菌活性最高的依次是美罗培南、业胺培南(99.2%～100%)、哌拉西林/三唑巴坦(90.8%～97.0%)、阿米卡星(83.8%～92.4%).头孢吡肟对肺炎克雷伯菌的活性高于其对大肠埃希菌的活性(85.4%vs.65.2%).对于阴沟肠杆菌、产气肠杆菌、弗劳地柠檬酸菌,活性最高的依次为美罗培南、亚胺培南(99.2%～100%)、阿米卡星(85.2%～92.6%)、头孢吡肟(81.5%～85.9%)、哌拉西林/三唑巴坦(73.4%～87.2%)、头孢哌酮/舒巴坦(65.6%～77.7%)和环丙沙星(53.1%～72.3%).对于铜绿假单胞菌,活性最高的药物依次为阿米卡星(83.5%)、美罗培南(79.1%)、哌拉西林/三唑巴坦(74.1%)和亚胺培南(70.9%).鲍曼不动杆菌对于亚胺培南、美罗培南、头孢哌酮/舒巴坦的敏感性最高,敏感率分别为79.1%、73.4%、59.7%.多重耐药的鲍曼不动杆菌达到53.0%.对于洋葱伯克霍尔德菌,抗菌活性较高的依次是美罗培南(73.3%)、头孢他啶(73.3%)、哌拉西林/三唑巴坦(62.2%).结论 碳青霉烯类对肠杆菌科仍保持高活性,但鲍曼不动杆菌、铜绿假单胞菌的耐药件明显增加,值得关注.
目的 鑑測2006年我國革蘭陰性桿菌的耐藥性.方法 收集2006年9-12月10傢教學醫院987株非重複的革蘭陰性桿菌.菌株經中心實驗室複覈後,採用瓊脂稀釋法測定美囉培南等廣譜抗菌藥物的最低抑菌濃度(MICs).結果 10種抗菌藥物對于629株腸桿菌科細菌的抗菌活性的敏感率由大至小依次為:美囉培南(敏感率99.8%)、業胺培南(敏感率99.5%)、哌拉西林/三唑巴坦(91.3%)、阿米卡星(89.3%)、頭孢吡肟(83.8%)、頭孢哌酮/舒巴坦(79.7%)、頭孢他啶(74.7%)、頭孢噻肟(57.7%)、頭孢麯鬆(56.6%)、環丙沙星(53.6%).大腸埃希菌中超廣譜β內酰胺酶(ESBL)的髮生率為59.0%,高于肺炎剋雷伯菌(33.0%)和奇異變形桿菌(8.0%).對于大腸埃希菌和肺炎剋雷伯菌,抗菌活性最高的依次是美囉培南、業胺培南(99.2%～100%)、哌拉西林/三唑巴坦(90.8%～97.0%)、阿米卡星(83.8%～92.4%).頭孢吡肟對肺炎剋雷伯菌的活性高于其對大腸埃希菌的活性(85.4%vs.65.2%).對于陰溝腸桿菌、產氣腸桿菌、弗勞地檸檬痠菌,活性最高的依次為美囉培南、亞胺培南(99.2%～100%)、阿米卡星(85.2%～92.6%)、頭孢吡肟(81.5%～85.9%)、哌拉西林/三唑巴坦(73.4%～87.2%)、頭孢哌酮/舒巴坦(65.6%～77.7%)和環丙沙星(53.1%～72.3%).對于銅綠假單胞菌,活性最高的藥物依次為阿米卡星(83.5%)、美囉培南(79.1%)、哌拉西林/三唑巴坦(74.1%)和亞胺培南(70.9%).鮑曼不動桿菌對于亞胺培南、美囉培南、頭孢哌酮/舒巴坦的敏感性最高,敏感率分彆為79.1%、73.4%、59.7%.多重耐藥的鮑曼不動桿菌達到53.0%.對于洋蔥伯剋霍爾德菌,抗菌活性較高的依次是美囉培南(73.3%)、頭孢他啶(73.3%)、哌拉西林/三唑巴坦(62.2%).結論 碳青黴烯類對腸桿菌科仍保持高活性,但鮑曼不動桿菌、銅綠假單胞菌的耐藥件明顯增加,值得關註.
목적 감측2006년아국혁란음성간균적내약성.방법 수집2006년9-12월10가교학의원987주비중복적혁란음성간균.균주경중심실험실복핵후,채용경지희석법측정미라배남등엄보항균약물적최저억균농도(MICs).결과 10충항균약물대우629주장간균과세균적항균활성적민감솔유대지소의차위:미라배남(민감솔99.8%)、업알배남(민감솔99.5%)、고랍서림/삼서파탄(91.3%)、아미잡성(89.3%)、두포필우(83.8%)、두포고동/서파탄(79.7%)、두포타정(74.7%)、두포새우(57.7%)、두포곡송(56.6%)、배병사성(53.6%).대장애희균중초엄보β내선알매(ESBL)적발생솔위59.0%,고우폐염극뢰백균(33.0%)화기이변형간균(8.0%).대우대장애희균화폐염극뢰백균,항균활성최고적의차시미라배남、업알배남(99.2%～100%)、고랍서림/삼서파탄(90.8%～97.0%)、아미잡성(83.8%～92.4%).두포필우대폐염극뢰백균적활성고우기대대장애희균적활성(85.4%vs.65.2%).대우음구장간균、산기장간균、불로지저몽산균,활성최고적의차위미라배남、아알배남(99.2%～100%)、아미잡성(85.2%～92.6%)、두포필우(81.5%～85.9%)、고랍서림/삼서파탄(73.4%～87.2%)、두포고동/서파탄(65.6%～77.7%)화배병사성(53.1%～72.3%).대우동록가단포균,활성최고적약물의차위아미잡성(83.5%)、미라배남(79.1%)、고랍서림/삼서파탄(74.1%)화아알배남(70.9%).포만불동간균대우아알배남、미라배남、두포고동/서파탄적민감성최고,민감솔분별위79.1%、73.4%、59.7%.다중내약적포만불동간균체도53.0%.대우양총백극곽이덕균,항균활성교고적의차시미라배남(73.3%)、두포타정(73.3%)、고랍서림/삼서파탄(62.2%).결론 탄청매희류대장간균과잉보지고활성,단포만불동간균、동록가단포균적내약건명현증가,치득관주.
Objective To investigate antimicrobial resistance among nosocomial gram-negative bacilli in 2006.Methods About 987 consecutive and non-repetitive gram-negative bacilli were isolated from 10 teaching hospitals from Sep.to Dec.in 2006 in China.All of these isolates were sent to the central laboratory for reidentification and susceptibility testing.The minimal inhibitory concentration(MICs)of meropenem and other antibacterial agents were determined by agar dilution method.Results The activity of antibacterial agents against Enterobacteriaceae was as fol lows in descending order of susceptible rate: meropenem(susceptible rate 99.8%),imipenem(99.5%),piperacillin/tazobactam(91.3%),amikacin (89.3%),cefepime(83.8%),cefoperazone/sulbactam(79.7%),ceftazidime(74.7%),cefotaxime (57.7%),ceftriaxone(56.6%),ciprofloxacin(53.6%).The prevalence of extended-spectrum β-Iactamases(ESBL)was 59.0% in Escherichia coli,33.0%in Klebsiella pneumoniae and 8.0%in Proteus mirabilis.The most active agents against E.coli and K.pneumoniae were meropenem,imipenem(99.2%. 100%),piperacillin/tazobactam(90.8%-97.0%),and amikacin(83.8%-92.4%).Cefepime Was more active against K.pneumoniae than E.coli(85.4% vs.65.2%).Against E.cloacae,E.aerogenes and Citrobacter freundii,the most active agents were as follows in desecnding order:meropenem,imipenem (99.2%-100%),amikacin(85.2%-92.6%),cefepime(81.5%-85.9%),piperacillin/tazobactam (73.4%-87.2%),cefoperazone/sutbactam(65.6%-77.7%),and ciprofloxacin(53.1%-72.3%).The most active agents against Pseudomonas aeruginosa were amikacin(83.5%),followed by meropenem (79.1%),piperacillin/tazobactam(74.1%),and imipenem(70.9%).The most susceptible agents against Acinetobacter baumannii were imipenem(79.1%),meropenem(73.4%) and cefoperazone/ sulbaetam(54.7%).Mutiresistant A.baumannii increased up to 53.0%.The most active agents against Burkholderia cepacia were meropenem(73.3%),eeflazidime(73.3%),and piperacillin/tazobactam (62.2%).Conclusions Carbapenems remained very high activity against Enterobacteriaceae.Increasing resistance to 10 antimicrobials agents tested from A.baumanni and P.aeruginosa brought great concern.
