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目的监测下呼吸道革兰阴性杆菌的耐药性。方法应用Ｅｔｅｓｔ法测定１７４株革兰阴性杆菌的ＭＩＣ，并根据ＮＣＣＬＳ（美国全国临床实验室标准委员会）的完全敏感折点判定其耐药比率。结果１９９６年分离株前５位的革兰阴性杆菌是硝酸盐阴性不动杆菌、绿脓杆菌、肺炎克雷伯菌、阴沟杆菌和大肠杆菌，抗菌药物耐药覆盖率较高的是头孢呋辛５６７％，阿莫西林加克拉维酸３７８％，氨曲南３３３％，氧氟沙星３２２％，庆大霉素３２２％。１９９７年分离株前５位的革兰阴性杆菌是硝酸盐阴性不动杆菌、绿脓杆菌、阴沟杆菌、肺炎克雷伯菌和荧光假单胞菌，抗菌药物耐药覆盖率较高的是头孢呋辛７８６％，头孢三嗪６７９％，替卡西林加克拉维酸４４０％，头孢哌酮４０５％，头孢噻肟４０５％。结论革兰阴性杆菌的耐药率普遍较高，临床上须根据细菌药敏结果合理应用抗菌药物。Ｅｔｅｓｔ是目前较为理想的一种药敏试验，其准确性高可靠性强，值得在临床上推广。
Objective To monitor the drug resistance of Gram-negative bacilli in lower respiratory tract. Methods The MICs of 174 strains of Gram-negative bacilli were determined by Etest and their resistance rates were determined according to NCCLS (National Committee for Clinical Laboratory Standards) completely sensitive points. Results The top 5 isolates of Gram-negative bacilli from 1996 to 1996 were nitrate-negative Acinetobacter, Pseudomonas aeruginosa, Klebsiella pneumoniae, Enterobacter cloacae and Escherichia coli. The high coverage rate of antibacterial drug was cefuroxime 56.7%, amoxicillin plus clavulanic acid 37.8%, aztreonam 33.3%, ofloxacin 32.2%, gentamicin 32.2%. Gram-negative bacilli of the top 5 isolates in 1997 were nitrate-negative Acinetobacter, Pseudomonas aeruginosa, Enterobacter cloacae, Klebsiella pneumoniae and Pseudomonas fluorescens. The highest coverage rate of antibacterials was cephosporium 78.6% of furosemide, 67.9% of ceftriaxone, 44.0% of ticarcillin and clavulanic acid, 40.5% of cefoperazone and 40.5% of cefotaxime. Conclusions Gram-negative bacilli generally have higher drug resistance rate. Clinically, antibacterial drugs should be applied reasonably according to the result of bacterial susceptibility. Etest is currently an ideal drug susceptibility test, its high accuracy and reliability, it is worth in the clinical promotion.