2005年老年患者主要耐药菌及耐药性分析  

Main pathogens and antimicrobial resistance in senile patients in 2005

作　　者：张润梅[1] 姚明兰[1] 刘国栋[1] 徐辉[1] 

机构地区：[1]山西医科大学第二医院药剂科,太原030001

出　　处：《中国药物与临床》2006年第9期672-675,共4页Chinese Remedies & Clinics

基　　金：山西省科技攻关基金资助项目(051095-5)

摘　　要：目的了解老年患者临床常见细菌菌种及对各种抗菌药物的耐药现状,以及各科室耐药菌分布频率。方法细菌鉴定主要采用法国生物梅里埃生物自动分析仪(ATB)。药敏试验采用纸片扩散法。数据分析采用WHONET5.3软件系统。结果共收集老年患者分离株2435株。铜绿假单胞菌298株,分离率12.1%;不动杆菌属245株,分离率10.1%;大肠埃希菌294株,分离率12.1%;肺炎克雷伯菌181株,分离率7.5%;阴沟肠杆菌88株,分离率3.6%;金黄色葡萄球菌182株,分离率7.5%;凝固酶阴性葡萄球菌252株,分离率10%;粪肠球菌102株,分离率4.2%;屎肠球菌45株,分离率1.8%;鸟肠球菌83株,分离率3.4%。大肠埃希菌、肺炎克雷伯菌产超光谱β-内酰胺酶(ESBLs)检出率分别为46.9%、29.3%。甲氧西林耐药的金黄色葡萄球菌(MRSA)90株,检出率49.4%,甲氧西林耐药的凝固酶阴性葡萄球菌203株,检出率80.6%;耐药性:非发酵糖细菌耐药率低于30%的有亚胺培南、头孢哌酮/舒巴坦;肠杆科细菌耐药率:除亚胺培南为0外,对三代头孢菌素耐药率较高。革兰阳性球菌对万古霉素耐药率为0;未发现万古霉素金黄色葡萄球菌(VRSA)、万古霉素中介的金黄色葡萄球菌(VISA)、耐万古霉素的肠球菌(VRE)等耐药菌。结论合理使用抗生素,降低细菌耐药性和采取有效措施控制其传播是非常重要的。Objective To investigate the main pathogens isolated clinically and their antimicrobial resistance and distribution in different ward in senile patients in our hospital in 2005. Methods The pathogens were identified by ATB expression microbe identification system. Disc diffusion test （K-Bmethod） was used to study the antimicrobial resistance. WHONET 5.3 was applied for analysis. Results Two thousand four hundred and thirty-five strains were collected which were isolated from senile patients. Pseudornonas aeruginosa are 298 and 12.1%; Acinetobacter are 245 and 10.1%; Escherichia coil are 294 and 12.1%; Klebsiella pneumoniae are 181 and 7.5%; Enterobacter cloacae are 88 and 4.00/0; Staphylococcus aureus are 182 and 7.5%; Coagulase-negaitive staphylococci are 252 and 10.3%; Enterococcus faecalis are 102 and 4.2%; Enterococcus faecium 45 and 1.8%; Enterococcus avium are 83 and 3.4%. The incidence of Escherichia coil and Klebsiella pneumoniae producing extended spectrum beta-lactamase isolates were 46.9% and 29.3%. Methicillin-resistant Staphylococcus aureus （MRSA） are 90 and the incidence is 49A%. Methicillin-resistant Coagulase-negaitive staphylococci （MRSCNS） are 203 and the incidence is 80.6%. The bacteria in which the glucose can not be fermented,with the antimicrobial resistance rate which under 30% are Imipenem and Cefoperazone/Sulbactam. In the Enterobacteriaceae, all of them had the lowest antimicrobial resistance to Imipenem （0）, and high antimicrobial resistance to the third generation cephalosporin. Gram stain positive coccus had the lowest antimicrobial resistance to Vancomycin （0）. We had not found VRSA,VISA,VRE. Concusion Antimicrobial resistance of clinical isolates threatens the success of infectious disease treatment. It is very important to promote the rational use of antimicrobial agents so that resistance is minimized,and to take effective containment for the control of the problem.

关 键 词：老年人 细菌 抗药性 

分 类 号：R446.5[医药卫生—诊断学]