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目的调查四川大学华西医院2004年9月-11月301株临床常见革兰阴性杆菌对第四代头孢菌素头孢吡肟的耐药状况,评价我院现采用的MICROSCAN细菌鉴定药敏系统中快速接种法的准确性。方法用琼脂稀释法、纸片扩散法、标准浊度法和MICROSCAN快速接种法测定头孢吡肟对301株细菌的体外抑菌活性。以琼脂稀释法为标准参考方法,比较其它三种方法与其一致性。结果琼脂稀释法测定301株革兰阴性杆菌对头孢吡肟的体外总敏感率为78.1%;纸片扩散法、标准浊度法和MICROSCAN快速接种法与标准参考方法的一致率分别为:99.0%、98.3%和95.3%。纸片扩散法、标准浊度法与琼脂稀释法无统计学差异,MICROSCAN快速接种法与琼脂稀释法有统计学差异。结论头孢吡肟对大部分临床常见革兰阴性杆菌具有良好的体外抗菌活性。纸片扩散法及标准浊度法结果准确性较高,我院现采用的MICROSCAN快速接种法的准确性有待进一步探讨。
Objective To investigate the resistance status of 301 clinical Gram-negative bacilli to cefepime in the fourth generation of cephalosporin in West China Hospital of Sichuan University from September to November in 2004. To evaluate the drug resistance of MICROSCAN bacteria Vaccination accuracy. Methods The antibacterial activities of cefepime against 301 strains of bacteria were determined by agar dilution method, disk diffusion method, standard turbidimetry and MICROSCAN rapid inoculation method. Agar dilution method as a standard reference method, compared with the other three methods and its consistency. Results The total sensitivity of 301 strains of gram-negative bacilli to cefepime was 78.1% when agar dilution method was used. The coincidence rate of diffusion method, standard turbidimetry and MICROSCAN rapid inoculation method with standard reference method was 99.0% , 98.3% and 95.3% respectively. Disk diffusion method, the standard turbidimetric method and agar dilution method was no significant difference, MICROSCAN rapid inoculation method and agar dilution method were statistically different. Conclusion Cefepime has good antibacterial activity against most of the common gram-negative bacilli in clinic. Disk diffusion method and the standard turbidity accuracy of the results of higher accuracy, our hospital is now using MICROSCAN rapid inoculation of the accuracy of the need to be further explored.