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目的了解2010年-2014年温州地区临床分离的肠杆菌科细菌对阿米卡星耐药性变化。方法收集2010年-2014年从温州医科大学附属第一医院住院患者各临床各标本中分离的肠杆菌科细菌,共8 293株。使用VITEK 2 Compact 60全自动微生物分析仪进行鉴定及药敏试验,采用WHONET 5.6软件对数据进行回顾性分析。结果肠杆菌科细菌对阿米卡星的耐药率较低。对阿米卡星耐药率前4位分别是弗劳地枸橼酸、肺炎克雷伯菌、大肠埃希菌和奇异变形杆菌。耐阿米卡星的大肠埃希菌对氨曲南、头孢菌素类、环丙沙星等其他抗生素耐药性>75%。耐阿米卡星的肺炎克雷伯菌对亚胺培南及厄他培南的耐药率分别高达44.58%和43.41%。耐头孢哌酮/舒巴坦的大肠埃希菌和耐头孢哌酮/舒巴坦的肺炎克雷伯菌对阿米卡星的体外敏感率高达86.10%和61.19%。结论阿米卡星对临床分离的常见肠杆菌科细菌具有较强的体外抗菌活性,特别是治疗耐碳青霉烯类药物的肠杆菌科细菌的可选择药物。
Objective To investigate the changes of amikacin resistance in Enterobacteriaceae from 2010 to 2014 in Wenzhou area. Methods A total of 8 293 strains of Enterobacteriaceae isolated from various clinical specimens of inpatients from the First Affiliated Hospital of Wenzhou Medical University from 2010 to 2014 were collected. The VITEK 2 Compact 60 automatic microbiological analyzer was used for identification and drug susceptibility testing. Data were analyzed retrospectively using WHONET 5.6 software. Results Enterobacteriaceae had a lower resistance rate to amikacin. The top four resistance rates to amikacin were freundy citrate, Klebsiella pneumoniae, Escherichia coli and Proteus mirabilis. Resistance to amikacin Escherichia coli aztreonam, cephalosporins, ciprofloxacin and other antibiotic resistance> 75%. The resistant rates of Klebsiella pneumoniae to amikacin to imipenem and ertapenem were as high as 44.58% and 43.41%, respectively. In vitro susceptibility of amikacin to Escherichia coli and cefoperazone / sulbactam-resistant Klebsiella pneumoniae was 86.10% and 61.19%, respectively. Conclusion Amikacin has strong in vitro antibacterial activity against common Enterobacteriaceae isolated clinically, especially for Enterobacteriaceae resistant to carbapenems.