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目的:了解贵州省2009年常见临床分离革兰阴性杆菌的耐药性情况,为临床治疗提供依据。方法:采用纸片扩散法(K-B法)进行药敏试验,以美国临床实验室标准化协会(CLSI)2009年版为判断标准,药敏试验结果使用世界卫生组织(WHO)提供的WHONET5.4软件进行统计分析。结果:收集2009年贵州省6家教学医院非重复临床分离革兰阴性杆菌共1620株,其中肠杆菌科1087株(67.1%),非发酵菌533株(32.9%)。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和克雷伯菌检出率分别为64.4%、34.5%。肠杆菌科细菌对碳青霉烯类药高度敏感,耐药率小于5%;其次为头孢哌酮/舒巴坦、哌拉西林/三唑巴坦和阿米卡星,耐药率均小于30%。铜绿假单胞菌和不动杆菌对美罗培南、亚胺培南的耐药率分别为17.6%、34.5%和15.2%、18.0%。结论:碳青霉烯类药对于肠杆菌科细菌保持高度活性,对于铜绿假单胞菌和不动杆菌的耐药率较高。
Objective: To understand the common clinical isolates of Gram-negative bacilli in Guizhou Province in 2009 and to provide basis for clinical treatment. Methods: Susceptibility test was conducted by the disk diffusion method (KB method). According to CLSI 2009 edition, the susceptibility test results were based on WHONET5.4 software provided by the World Health Organization (WHO) Statistical Analysis. Results: 1620 non-repetitive clinical isolates of Gram-negative bacilli from 6 teaching hospitals in Guizhou province were collected, including 1087 strains (67.1%) of Enterobacteriaceae and 533 strains (32.9%) of non-fermentative bacteria. The detection rates of Escherichia coli and Klebsiella producing ESBLs were 64.4% and 34.5% respectively. Enterobacteriaceae were highly sensitive to carbapenems, and the resistance rate was less than 5%. The second was cefoperazone / sulbactam, piperacillin / tazobactam and amikacin, and the resistance rate was less than 30%. The rates of resistance to meropenem and imipenem in Pseudomonas aeruginosa and Acinetobacter were 17.6%, 34.5% and 15.2%, 18.0%, respectively. Conclusion: Carbapenems are highly active against Enterobacteriaceae and resistant to Pseudomonas aeruginosa and Acinetobacter.