Etest监护病房革兰阴性杆菌耐药性的7年动态研究.doc

Etest监护病房革兰阴性杆菌耐药性的7年动态研究 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：Etest监护病房革兰阴性杆菌耐药性的7年动态研究 1 1 材料与方法 3 (5)统计学处理 数据采用软件分析结果。 5 2 结果 5 3 讨论 6 文2：我院住院患者抗菌药物应用与革兰阴性杆菌耐药情况分析 9 1资料与方法 9 参考文摘引言： 13 原创性声明（模板） 14 文章致谢（模板） 15 正文 Etest监护病房革兰阴性杆菌耐药性的7年动态研究 文1：Etest监护病房革兰阴性杆菌耐药性的7年动态研究 ABSTRACT Objective To investigate the resistant rates of Gram-negative bacilli in ICU and ESBLs-producting strai. Method Using E-test to detect the minimal inhibition concentration (MIC) of 12 antibiotics agait 108 strai of Gram-negative bacilli. Results The drug-resistance rate of imipenem is the lowest one, %; cefoperzoneulbactam, amikacin, cefepime, piperacillitazobactam, ticarcilliclavulanic acid ceftazidime and ertapenem have slightly higher drug-resistance rates of around %～49%, for othe 60%～%. Twenty-four strai of ESBLs-producing bacilli have been selected from Escherichia coli and Klebsiella pneumoniae, the positive rates are % and 53% respectively. Imipenem is susceptible to all Escherichia coli and Klebsiella pneumoniae. Compared to the survey in the last six yea, the drug-resistant rate of cefoperzoneulbactam is increased from % to 37%, ceftazidime increased from % in 1998 to 49% in 2005, other drugs have changed significantly except piperacillitazobactam and ticarcilliclavulanic. Conclusion Imipenem remai the highest antibacterial activity agait all the detected strai and is still effective to ESBLs-producing strai; in the last 7 yea, due to the abuse of antibiotics with β-lactamase inhibito leads to drug-resistant rate increase significantly. KEY WORDS Gram-negative bacilli; Drug- resistance; E-test; ESBL 近半个世纪以来，革兰阴性杆菌已成为 医院 感染的重要致病菌， 治疗 这类感染的抗菌药物主要是第三代头孢菌素和单环类抗菌药物。随着这两类药物的广泛应用，细菌耐药率逐年增加且出现多重耐药的特点。哈佛大学医学院连续9年的监测研究显示［1］，1994年～2002年间，多重耐药的大肠埃希菌从%增至%，肠杆菌属细菌从%增至%，铜绿假单胞菌从%增至%，且多重耐药的模式扩大，从第三代头孢菌素到氨基糖苷类及喹诺酮类抗菌药物。国内医院感染革兰阴性杆菌的耐药情况更严峻，据国家细菌监测中心报道［2］，1999年～2002年北京、广州、湖北和辽宁等地区临床分离的大肠埃希菌、克雷伯菌属对头孢噻肟/克拉维酸、头孢他啶的耐药率明显增加。4年间上述地区临床分离的大肠埃希菌对头孢噻肟/克拉维酸的耐药率分别由%、%、%和%上升至%、%、