1017株临床分离细菌耐药谱和耐药机制的研究  

Analysis of drug resistance spectrum and its mechanism in 1017 clinical bacterial isolates

作　　者：耿穗娜[1] 芮勇宇[1] 王前[1] 牟成惠[1] 周晓红[1] 张洁[1] 

机构地区：[1]南方医科大学南方医院检验科,广东广州510515

出　　处：《第一军医大学学报》2005年第12期1529-1532,1545,共5页Journal of First Military Medical University

摘　　要：目的了解本院临床分离细菌的耐药谱和耐药机制,为合理使用抗生素提供依据。方法分离的细菌用BDPhoenix仪鉴定,药敏用K-B法,数据分析用WHONET5软件。结果1017株细菌中前6位为铜绿假单胞菌、凝固酶阴性葡萄球菌(CNS)、大肠埃希菌、金黄色葡萄球菌(SA)、粪肠球菌和肺炎克雷伯菌,分别为19.37%、17.70%、13.27%、12.09%、11.8%和7.57%。G-杆菌中,亚胺培南敏感率最高(81.5%),头孢他啶敏感率大于70%。大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)的阳性率分别为34.8%和45.5%。G+球菌中,万古霉素和替考拉宁敏感率分别为99.0%和100.0%,呋喃妥因、亚胺培南、阿米卡星、哌拉西林/他唑巴坦敏感率大于70%。CNS和SA耐苯唑西林比率分别为78.2%和46.8%。结论本院临床细菌产ESBLs和耐苯唑西林比率高,应加强抗生素的合理使用和采取有效的隔离措施以降低耐药率及多重耐药菌的扩散。Objective To investigate the drug susceptibility of the clinical bacterial isolates to provide evidence for more adequate use of antibiotics. Methods Altogether 1017 clinical bacterial isolates were identified by BD Phoenix and tested for resistance against antimicrobial agents by K-B method. WHONET5 was applied for the analysis. Results The most frequent bacteria detected included P aeruginosa （19.37%）, coagulase-negative Staphylococci （CNS, 17.70%）, E. coli （13.27%）, S. aureu （SA, 12.09%）, E.faecalis （11.8%）, and K. pneumoniae （7.57%）. In gram-negative isolates, the susceptibility rate ofimipenem was 81.5%, and that of ceftazidime was above 70%. The incidences of E.coli and K. pneumoniae isolates producing extended spectrum beta-lactamase （ESBLs） were 34.8% and 45.5% respectively. In gram-positive isolates, the susceptibility rates of vancomycin and Teicoplanin were 98.8% and 100.0% respectively, and those of furazolidone, imipenem, amikacin, piperacillin/tazobactam were above 70%. The oxacillin resistant rates of CNS and SA were 78.2% and 46.8%. Conclusion The 1017 clinical bacterial isolates are characterized by high ratio of ESBL production and oxacillin resistance, suggesting the importance of adequate use of antimicrobial agents and effective control measures for reducing the drug resistance and preventing the spread of multi drugresistant bacteria.

关 键 词：细菌 耐药 超广谱Β-内酰胺酶 甲氧西林抗菌性 

分 类 号：R446.5[医药卫生—诊断学]