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目的分析自临床分离的对亚胺培南耐药与敏感铜绿假单胞菌对常用抗生素的耐药谱特性,以期指导临床合理使用抗生素。方法采用稀释法对在1997年1月~2002年12月间从临床分离的铜绿假单胞菌进行19种常用抗菌药物敏感性测定;使用χ2检验比较亚胺培南耐药组与敏感组铜绿假单胞菌在耐药性之间的差别。结果共检测689株铜绿假单胞菌,对亚胺培南耐药85株(12.3%)、中介53株(7.7%)、敏感551株(80%),美洛培南的药敏谱与亚胺培南相似。亚胺培南耐药组与敏感组铜绿假单胞菌均对多粘菌素E高度敏感;两组菌株对磷霉素的耐药率均较高,其差异无显著意义(P>0.05);两组菌株对氨苄西林/舒巴坦及复方新诺明全部耐药。对包括美洛培南、头孢吡肟、头孢他啶、氨曲南、环丙沙星及丁胺卡那在内的其余14种抗生素的耐药率均为耐药组明显高于敏感组(P<0.01)。结论与自临床分离的对亚胺培南敏感铜绿假单胞菌相比,对亚胺培南耐药铜绿假单胞菌对大多数常用抗菌药物呈现出更强的耐药性;并且对亚胺培南耐药铜绿假单胞菌的多重耐药状况非常严重。因亚胺培南耐药铜绿假单胞菌所致的感染,临床上选用抗菌药物时应以抗菌药物敏感性试验结果为依据。
OBJECTIVE: To analyze the resistance spectrum of commonly used antibiotics against imipenem and sensitive Pseudomonas aeruginosa isolated from clinic in order to guide the rational use of antibiotics in clinic. Methods Nineteen commonly used antimicrobial susceptibility tests of Pseudomonas aeruginosa isolated from clinical isolates from January 1997 to December 2002 were performed using the dilution method. Chi-square test was used to compare the susceptibility between imipenem-resistant group and sensitive group Pseudomonas in the difference between drug resistance. Results A total of 689 strains of Pseudomonas aeruginosa were detected, 85 (12.3%) were resistant to imipenem, 53 (7.7%) and 551 (80%) were resistant to imipenem. Imipenem is similar. The imipenem-resistant group and the sensitive group Pseudomonas aeruginosa were highly sensitive to polymyxin E. The resistance rates of both strains to fosfomycin were high, with no significant difference (P> 0.05) Both strains were resistant to ampicillin / sulbactam and cotrimoxazole. The resistance rates of the other 14 antibiotics including meropenem, cefepime, ceftazidime, aztreonam, ciprofloxacin and amikacin were significantly higher in the drug-resistant group than in the susceptible group (P < 0.01). Conclusion Compared with imipenem-sensitive Pseudomonas aeruginosa isolated from clinic, imipenem-resistant Pseudomonas aeruginosa showed more resistance to most commonly used antibiotics; Amipenem-resistant Pseudomonas aeruginosa multi-drug resistance situation is very serious. Due to imipenem-resistant infections caused by Pseudomonas aeruginosa, clinical trials of antimicrobial agents should be based on antimicrobial susceptibility test results.