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监测常见医院感染菌对 7种第三代头孢菌素的耐药性 ,以指导临床用药。方法 采用肉汤稀释法测定从我院重症监护病房及其它地方分离的 6种革兰阴性杆菌和 2种革兰阳性球菌共 2 81株细菌的最低抑菌浓度(MIC)。结果 7种抗生素中头孢哌酮 /舒巴坦 (舒普深 )对革兰阴性杆菌的总耐药率最低为 12 .7% ,其次是亚胺培南 /西司他丁 (泰能 ) 13.6 %和头孢他啶 2 9.5 %。若排除嗜麦芽窄食单胞菌则亚胺培南 /西司他丁 (泰能 )对其他菌的耐药率最低为 4.5 %。肠杆菌科的大肠埃希菌和肺炎克雷伯菌产生超广谱β-内酰胺酶 (ESBL )为 11.9%。葡萄球菌和肠球菌对第三代头孢菌素的耐药率 >70 %。结论 院感菌对亚胺培南 /西司他丁 (泰能 )、头孢哌酮 /舒巴坦 (舒普深 )和头孢他啶耐药率最低 ,氨曲南和第三代头孢菌素对革兰阴性产酶菌呈现交叉耐药性 ,而对革兰阳性球菌基本无效。
To monitor the common hospital infection bacteria on the 7 third-generation cephalosporin resistance to guide clinical medication. Methods The minimum inhibitory concentration (MIC) of 2 81 bacteria from 6 Gram-negative bacilli and 2 Gram-positive cocci isolated from ICU and other places in our hospital was determined by broth dilution method. Results The lowest resistance rate of cefoperazone / sulbactam (Shu Pu Shen) to Gram-negative bacilli among the seven antibiotics was 12.7%, followed by imipenem / cilastatin 13.6 % And ceftazidime 2 9.5%. If the exclusion of Stenotrophomonas maltophilia, imipenem / cilastatin (Thailand to) the lowest resistance rate of other bacteria was 4.5%. Enterobacteriaceae Escherichia coli and Klebsiella pneumoniae produce extended spectrum β-lactamase (ESBL) of 11.9%. Staphylococcus aureus and enterococci third-generation cephalosporin resistance rate of> 70%. Conclusion The susceptible rate of nosocomial bacteria to imipenem / cilastatin (celestine), cefoperazone / sulbactam (shuopunshen) and ceftazidime was the lowest, while that of aztreonam and third generation cephalosporins Gram-negative bacteria produce cross-resistance, but almost no effect on Gram-positive cocci.