广西地区临床常见致病菌耐药性监测  

Drug resistance surveillance of common bacteria of clinical isolation in Guangxi in 2001

作　　者：农生洲[1] 覃桂芳[1] 唐萍[1] 王勇[1] 陈松锋[1] 叶群南[1] 周孝贞[1] 

机构地区：[1]广西壮族自治区人民医院,南宁530021

出　　处：《广西医学》2004年第12期1756-1760,共5页Guangxi Medical Journal

基　　金：广西自然科学基金资助项目 (桂科青 0 135 0 17)

摘　　要：目的　了解广西地区临床常见致病菌对常用抗生素的耐药状况。方法　收集广西地区的 136家二级以上医院2 0 0 1年临床分离的致病菌 ,对常见致病菌采用纸片琼脂扩散法测定 2 0种抗生素对临床常见革兰氏阴性杆菌和 13种抗生素对临床常见革兰氏阳性球菌的体外药物敏感性。按NCCLS标准判断结果 ,利用WHONET5软件进行统计和分析。结果　临床分离的常见致病菌为 :肠杆菌科细菌的大肠埃希菌、克雷伯菌属、枸橼酸菌属、沙雷菌属、变形杆菌属和肠杆菌属等 ;非发酵菌的铜绿假单胞菌、不动杆菌、嗜麦芽假单胞菌等 ;革兰氏阳性球菌的金黄色葡萄球菌、凝固酶阴性葡萄球菌、粪肠球菌和屎肠球菌等。这些菌株占总数的 80 %以上 ,其中肠杆菌科细菌中大肠埃希菌和克雷伯菌属ESBLs检出率分别为 33.92 %和 36 .90 % ,葡萄球菌中MRSA和MRCNS检出率分别为 38.5 2 %和 4 9.77%。在耐药性方面 ,肠杆菌科细菌除对亚胺培南仍有 10 0 %敏感率外 ,其它药物均有近 5 %的耐药率。非发酵菌对常用抗生素的耐药率则均在 5 0 %或以上。肠球菌高耐株为 5 4 .8%。未发现有耐万古霉素葡萄球菌菌株出现 ,耐万古霉素肠球菌株有 0 .37%。结论　广西地区细菌耐药状况较为严重。各地医院必须加强细菌耐药性检测 ,及时掌握耐药性的变迁 。Objective To investigate the drug resistance to commonly used antibiotics of clinical common bacteria isolations obtained from 136 hospitals in Guangxi.Methods Bacterial susceptibility tests were performed using Kirby-Bauer method,the results were analyzed according to NCCLS by WHONET 5 software.Results More than 80% of microorganisms from clinic were belong to entero-bacteriaceae, nonfermenters, staphylococci,enterococcus. They were E.coli,Klebsiella,Citrobacter,Enterobacter,Proteus, P.aerugiinosa,A.baumanuii,S.maltophi, S.aureus,coagulase negative staphylococci(CNS) and E.faecalis,E.faecium.There were 33.92% and 36.90% ESBLs tested from E.coli and Klebsiella. Resistant rates of Enterobacteriaceae against commonly used antibiotics were around 50% , The one only still all sensitive was imipenem. In the nonformerters, the resistant rates were around 50% or higher. In the staphylococcus ,MRSA and MRSCNS were 38.52% and 49.77% , all isolates of the staphylococcusstill are sensitive to vancomycin .but enterococcus was already 0.37% resistant to vancomycin , and there were 54.80% of the resistant of GN(100μg).Conclusion The rates of bacterial resistance and multi-drug resistance is a serious problem in Guangxi. It is important and urgent to carry out surveillance of bacterial resistance for appropriate using of antibiotics to effectively control the increasing of the rates of bacterial resistance and multi-drug resistance.

关 键 词：病原菌 抗生素 药物敏感试验 细菌耐药监测 

分 类 号：R37[医药卫生—病原生物学]