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我院2004－2016年3种非发酵革兰氏阴性杆菌耐药性分析
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| 篇名： | 我院2004－2016年3种非发酵革兰氏阴性杆菌耐药性分析 |
| TITLE： | |
| 摘要： | 目的：为临床合理选用针对非发酵革兰氏阴性杆菌的抗菌药物提供参考。方法：收集青岛大学附属医院（以下简称“我院”）2004年1月－2016年12月临床分离的铜绿假单胞菌（PA）、鲍曼不动杆菌（AB）、嗜麦芽窄食单胞菌（SM）的病原学资料，回顾性分析其对常用抗菌药物的耐药情况。结果：共检出PA 15 587株、AB 7 446株、SM 2 950株。PA对常用抗菌药物的耐药率虽有波动，但整体呈下降趋势；除亚胺培南外，PA对其他常用抗菌药物的耐药率均明显下降，其中对阿米卡星、庆大霉素的耐药率分别降至4.60％、7.48％。AB对大部分常用抗菌药物的耐药率均超过了40％，但对替加环素较为敏感（耐药率为0～4.03％）。SM对头孢哌酮钠舒巴坦钠的耐药率由2004年的3.03％上升至2016年的39.01％，但对复方磺胺甲噁唑、米诺环素、左氧氟沙星较为敏感。结论：我院检出的非发酵革兰氏阴性杆菌以PA为主。PA对大部分抗菌药物的耐药率呈下降趋势，AB的耐药情况严峻，SM对头孢哌酮钠舒巴坦钠的耐药率呈上升趋势。对上述3种非发酵革兰氏阴性杆菌敏感的药物包括阿米卡星、替加环素、米诺环素等，临床应根据药敏试验结果合理选用。 |
| ABSTRACT： | OBJECTIVE： To provide reference for rational selection of antibiotics against non-fermentative Gram-negative bacilli in clinic. METHODS： Etiological data of clinical isolated Pseudomonas aeruginosa （PA）， Acinetobacter baumanii （AB） and Stenotrophomonas maltophilia （SM） were collected from the Affiliated Hospital of Qingdao University （called “our hospital” for short） during Jan. 2004-Dec. 2016. Drug resistance of them to commonly used antibiotics was analyzed retrospectively. RESULTS： Totally 15 587 strains of PA， 7 446 strains of AB and 2 950 strains of SM were detected. Resistance rates of PA to commonly used antibiotics fluctuated but were in a decreasing tendency. Except for imipenem， resistance rates of PA to commonly used antibiotics decreased significantly， and resistance rates of PA to amikacin and gentamicin decreased to 4.60％ and 7.48％， respectively. Resistance rates of AB to most commonly used antibiotics were more than 40％， but it was sensitive to tigecycline （drug resistance of 0-4.03％）. Resistance rates of SM to cefoperazone sodium and sulbactam sodium increased from 3.03％ in 2004 to 39.01％ in 2016， but it was sensitive to sulfamethoxazole， minocycline and levofloxacin. CONCLUSIONS： Non-fermentative Gram- negative bacilli detected in our hospital are mainly PA. Resistance rate of PA to most of the antibiotics is declining； drug resistance of AB is severe； resistance rates of SM to cefoperazone sodium and sulbactam sodium show increasing tendency. Above 3 non-fermentative Gram-negative bacilli are sensitive to amikacin， tegocycline and minocycline. Clinical selection should be based on the results of drug sensitivity test. |
| 期刊： | 2018年第29卷第6期 |
| 作者： | 李祥鹏，秦贤，荆凡波，梁瑜，赵俊，韩冰，魏丽娜，纪洪艳，隋忠国 |
| AUTHORS： | LI Xiangpeng，QIN Xian，JING Fanbo，LIANG Yu，ZHAO Jun，HAN Bing，WEI Lina，JI Hongyan，SUI Zhongguo |
| 关键字： | 非发酵革兰氏阴性杆菌；铜绿假单胞菌；鲍曼不动杆菌；嗜麦芽窄食单胞菌；抗菌药物；耐药性 |
| KEYWORDS： | Non-fermentative Gram-negative bacilli； Pseudomonas aeruginosa； Acinetobacter baumanii； Stenotrophomonas maltophilia； Antibiotics； Drug resistance |
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