奇异变形杆菌耐药性变迁10年连续监测分析

年华; 褚云卓; 田素飞; 郭丽洁; 丁丽萍

doi:10.11847/zgggws2012-28-08-42

奇异变形杆菌耐药性变迁10年连续监测分析

Continuous monitoring of clinical distribution and drug resistance of Proteus mirabilis

摘要

摘要: 目的了解奇异变形杆菌临床分布及耐药性变迁情况,为临床医生合理应用抗生素提供依据.方法收集2001—2010年临床分离的奇异变形杆菌844株,采用VITEK-2和PHEONIX系统对细菌进行鉴定,采用K-B纸片扩散法和自动化仪器进行药敏试验,用WHONET 5.4软件进行数据分析.结果 844株奇异变形杆菌中,分离于尿液304株(占36%),其次为痰液263株(占31.2%),分泌物176株(占20.9%);奇异变形杆菌对头孢类抗生素耐药率随着时间明显增高,对亚胺培南和美罗培南的耐药率为3%左右,2005年后对喹诺酮类抗生素的耐药率明显增高(>50%);2008、2009、2010年产超广谱β-内酰胺酶菌株分别占45.63%、56.98%、37.2%.结论奇异变形杆菌对头孢菌素和喹诺酮类抗生素耐药率明显升高,碳青酶烯类和酶抑制剂类抗生素对其仍然保持较好抗菌活性.

Abstract: Objective To assess the variations of clinical distribution and drug resistance of Proteus mirabilis and to provide reference for clinical selection of antibiotics.Methods The bacteria were identified by VITEK-2 and PHEONIX system.Antibiotic sensitivity test was conducted with Kirby-Bauer method and automatic machine.The data were analyzed by WHONET 5.4 software.Results There were 844 isolates of Proteus mirabilis during the 10 year's monitoring,with 304 from urine(36.0%),263 from sputum(31.2%),and 176 from secretion(20.9%).The rate of extended-spectrum β-lactamases(ESBLs)production was 45.6%,57.0%,and 37.2% for the isolates in 2008,2009,and 2010,respectively.The drug resistance rate of Proteus mirabilis to cephalosporin increased with the time and the rate to carbapenem was 3.0%.The resistance rate to quinolones obviously increased after 2005.Conclusion The drug resistance rate to quinolones and cephalosporin increased in recent years but carbapenem and enzymeinhibitor still maintain well antimicrobial activity to Proteus mirabilis.

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