摘要目的 了解布鲁氏菌对抗菌药的敏感性,为临床医生合理用药、有效治疗布鲁氏菌病患者提供科学依据.方法 于2014至2016年,收集玉溪市5县2区确诊布鲁氏菌病患者血液中分离培养的41株布鲁氏菌,采用纸片扩散法(K-B法)检测其对23种抗菌药的敏感性试验,并记录抗菌药对布鲁氏菌抑菌环的大小,依据药敏试验指南(2009年版)判读敏感性试验结果.结果 布鲁氏菌对氧氟沙星、环丙沙星、左氧氟沙星和阿米卡星敏感率为100.00％,对头孢噻肟、头孢吡肟、亚胺培南、多西环素、头孢哌酮、米诺环素、妥布霉素、利福平、头孢哌酮/舒巴坦、氯霉素敏感率均在90％以上;布鲁氏菌对抗菌药耐药率较高的是氨曲南(87.80％),其次为氨苄西林(41.46％);布鲁氏菌对多西环素出现中介菌株,对利福平出现中介和耐药菌株.结论 治疗布鲁氏菌病的常用药多西环素和利福平的敏感率较高,但已出现中介菌株;氟喹诺酮类和头孢菌类药物对布鲁氏菌敏感率较高,可以考虑治疗中选择此药.

abstractsObjective To investigate the antimicrobial susceptibility of Brucella and to provide a scientific basis for rational drug use and effective treatment of patients with brucellosis.Methods A total of 41 Brucella strains were isolated from the blood of patients with brucellosis in 5 counties and 2 districts in Yuxi City,China from 2014 to 2016.The susceptibility to 23 antimicrobial drugs was tested using Kirby-Bauer(K-B) disk diffusion method and the sizes of antimicrobial rings were recorded.The susceptibility testing results were interpreted according to the Drug Susceptibility Testing Guideline (2009 version).Results The susceptibility rate of Brucella was 100.00％ to ofloxacin,ciprofloxacin,levofloxacin,and amikacin and ＞90％ to cefotaxime,cefepime,imipenem,doxycycline,cefoperazone,minocycline,tobramycin,rifampicin,cefoperazone/sulbactam,and chloramphenicol.The high resistance to aztreonam and ampicillin was observed (87.80％ and 41.46％).Doxycycline-intermediate strains,rifampicin-intermediate strains,and rifampicin-resistant strains were identified.Conclusion Doxycycline and rifampicin are commonly used in the treatment of brucellosis,but doxycycline/rifampicin-intermediate and-resistant strains have been identified.The susceptibility of Brucella to fluoroquinolones and cephalosporins was high,so the two drugs can be considered in the treatment of brucellosis.