摘要
目的了解近7年间重庆一医院肠道外分离的气单胞菌对临床常用药物耐药情况,为临床合理选择抗菌药物提供客观依据。方法回顾性分析2010|2016年住院患者肠道外分离的非重复气单胞菌株的临床分布特征并对14种抗菌药物的体外药敏结果进行判读,采用WHONET5.6软件进行数据分析。结果 2010|2016年共分离肠道外非重复气单胞菌230株,以嗜水气单胞菌最为常见,占83.0%,其次为维氏气单胞温和生物变种,占14.8%。主要分离自伤口分泌物,其次为胆汁和尿液。气单胞菌对甲氧苄啶-磺胺甲唑耐药最为严重,耐药率为46.8%,其次为头孢曲松(37.0%)和头孢呋辛(28.8%),对氨曲南、头孢吡肟、环丙沙星的耐药率在10%以上。对哌拉西林-他唑巴坦、头孢西丁、左氧氟沙星、阿米卡星和庆大霉素以及碳青霉烯类抗菌药物的耐药率低于10%。其中,对亚胺培南耐药率为4.0%,对美罗培南耐药率为1.7%。除对哌拉西林-他唑巴坦、亚胺培南和阿米卡星外,嗜水气单胞菌对其他抗菌药物耐药率均高于维氏气单胞温和生物变种。尚未发现维氏气单胞温和生物变种对美罗培南耐药菌株。结论该院临床分离气单胞菌肠道外感染以嗜水气单胞菌和维氏气单胞温和生物变种为主。气单胞菌科不同菌种对抗生素的耐药率有差别。由于气单胞菌对甲氧苄啶-磺胺甲唑和第三代头孢菌素耐药较为严重,临床应慎重使用。
Objective To evaluate the antibiotic resistance profile of the Aeromonas strains isolated from extra-intestinal specimens during 7-year period in a tertiary hospital in Chongqing for appropriate antibiotic treatment. Methods WHONET 5.6 software was used to analyze the clinical data and results of antimicrobial susceptibility testing of Aeromonas strains to 14 antibiotics according to CLSI breakpoints(CLSI-M45-A3). Results A total of 230 non-duplicate Aeromonas strains were collected from January 2010 to December 2016. The most common species were Aeromonas hydrophila(83.0%) and Aeromonas sobria(14.8%). Majority of the strains were isolated from wound secretion, bile and urine. Overall, 46.8% of the Aeromonas isolates were resistant to trimethoprim-sulfamethoxazole, followed by ceftriaxone(37.0%) and cefuroxime(28.8%). More than 10% of the strains were resistant to aztreonam, cefepime and ciprofloxacin. More than 90% of the strains were susceptible to piperacillin-tazobactam, cefoxitin, levofloxacin, gentamicin, amikacin, imipenem and meropenem. Only 4.0% and 1.7% of the strains were resistant to imipenem and meropenem, respectively. Aeromonas hydrophila showed higher antibiotic resistance than Aeromonas sobria to all the antibiotics tested except piperacillin-tazobactam, imipenem, and amikacin. None of the Aeromonas sobria isolates was found resistant to meropenem. Conclusions The Aeromonas hydrophila and Aeromonas sobria isolates are the dominant Aeromonas species in Chongqing. The antibiotic resistant profiles vary with Aeromonas species and site of infection. The use of third generation cephalosporins and trimethoprim-sulfamethoxazole should be cautious in Aeromonas infection due to the high resistance level.
作者
赫童
杨双双
邓铃俊
严立
张莉萍
HE Tong;YANG Shuangshuang;DENG Lingjun;YAN Li;ZHANG Liping.(Department of Laboratory Medicine, the First Affliated Hospital of Chongqing Medical University, Chongqing 400016, China)
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2017年第6期653-657,共5页
Chinese Journal of Infection and Chemotherapy
基金
重庆市科学技术委员会基础与前沿一般项目(cstc2016jcyj A0248)
