|摘要||目的 建立全国性细菌耐药监测网,了解我国细菌耐药流行情况.方法 以标准平皿二倍稀释法测定抗菌药物最低抑菌浓度(MIC),并按国家临床实验室标准委员会2004年标准计算细菌敏感度与耐药率.结果 按照监测方案,收集2004年10月1日至2005年9月30日全国15座城市17家医院的4 075株临床分离致病菌,行MIC测定.其中革兰阴性菌3 150株,占77.3%.肠杆菌科细菌对碳青霉烯类抗生素保持较高敏感度,拉氧头孢、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦和头孢吡肟等具有较好的抗菌活性,耐药率<10%.非发酵革兰阴性菌中铜绿假单胞菌和鲍曼不动杆菌对亚胺培南的耐药率分别为10.6%和10.4%,酶抑制剂复方制剂和氟喹诺酮类药物也有较强抗菌作用.结论 大肠埃希菌和鲍曼不动杆菌耐药率增长明显,喹诺酮及氨基糖苷类药物对肠杆菌科细菌抗菌作用并不高,应引起广泛关注.
Objective To establish a national antibacterial resistance surveillance network and explore the epidemiology of bacterial resistance in China. Methods The minimal inhibitory concentration (MIC) was determined by National Committee for Clinical Laboratory Standards (NCCLS) standard agar double dilution method. The susceptibility and resistance rates of drugs were calculated according to the criteria in guidelines of NCCLS (2004). Results According to the previous protocol, a total of 4 075 pathogenic strains isolated from 17 hospitals located at 15 different cities from October 1, 2004 to September 30, 2005 in China were collected and the MICs were detected. Gram-negative bacilli were 3 150 strains ( 77.3%). Enterobacteriaceae Were highly susceptible to Carbapenems. In addition, Moxalactam, Piperacillin/Tazobactam, Cefoperazone/Sulbactam and Cefepime were also exhibited good antibacterial activities against Enterobacteriaceae,the resistance rates of them were less than 10 %. The resistance rates of nonfermentative Gramnegative bacilli, such as Pseudomonas aeruginosa and Acinetobacter baumanii, to Imipenem were 10. 6 % and 10.4 % , respectively. Cefoperazone/Sulbactam, Piperacillin/Tazobactam and Fluoroquinolones also showed good activity against nonfermentative Gram-negative bacilli.Conclusions The drug resistance rates of Escherichia coli and Acinetobacter baumanii increase obviously. Fluoroquinolones and Aminoglycosides are not very effective against Enterobacteriaceae,which should be paid more attention.|