铜陵地区2005年度细菌耐药性监测与分析  

Surveillance of bacterial resistance in Tongling area

作　　者：宋有良[1] 潘晓龙[2] 周东升[2] 高晓坤 钱泽平 朱向阳 刘三保 黄义泽[1] 吴同生[1] 

机构地区：[1]安徽省铜陵市人民医院感染科,244000 [2]安徽省铜陵市人民医院检验科,244000 [3]铜陵有色职工总医院检验科 [4]铜陵市第四人民医院检验科 [5]铜陵县人民医院检验科 [6]铜陵市第二人民医院检验科

出　　处：《中国感染与化疗杂志》2006年第5期325-330,共6页Chinese Journal of Infection and Chemotherapy

基　　金：安徽省铜陵市科技计划项目经费资助课题(项目编号02A2222)。

摘　　要：目的了解安徽省铜陵地区临床分离菌株耐药状况。方法2005年1—12月铜陵地区临床分离菌株用Kirby-Bauer法进行药敏试验。结果1363株细菌中革兰阳性菌470株占34．5％,革兰阴性菌893株占65．5％。耐甲氧西林金葡菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)分别占金葡菌和凝固酶阴性葡萄球菌(CNS)的18．3％和84．3％。MRSA和MRCNS对庆大霉素、环丙沙星、复方磺胺甲嗯唑、克林霉素及红霉素等均高度耐药;对磷霉素、利福平、氯霉素和呋喃妥因等耐药率较低;未见耐万古霉素和替考拉宁葡萄球菌。粪肠球菌对青霉素、氨苄西林、高浓度的庆大霉索、磷霉素、氯霉素和环丙沙星等耐药率较低;屎肠球菌对四环素、磷霉素和氯霉素等耐药率较低;未见耐万古霉素和替考拉宁肠球菌。肠杆菌科细菌对氨苄西林、哌拉西林高度耐药;大肠埃希菌和克雷伯菌属中产ESBLs株分别占41．3％和36．5％．产ESBLs株对19种抗菌药物的耐药率均较非产ESBLs株高．对亚胺培南均无耐药。非发酵菌对亚胺培南、头孢哌酮一舒巴坦、哌拉西林-三唑巴坦和头孢他啶等耐药率较低。结论未发现糖肽类耐药的革兰阳性球菌;革兰阴性菌对亚胺培南、头孢哌酮-舒巴坦、哌拉西林-三唑巴坦等耐药率低。加强细菌耐药性监测,对合理使用抗菌药物、减少耐药菌株的产生和流行有重要临床指导价值。Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area. Methods Antimicrobial susceptibility test were conducted by Kirby-Bauer method. Results Of the 1 363 clinical isolates, gram positive organisms ac counted for 34.5%, gram negative organisms 65.5%. MRSA and MRCNS accounted for 18.3% and 84.3% of S. aureus and coagulase negative Staphylococci respectively. MRSA and MRCNS showed higher resistance to gentamicin, ciprofloxacin, SMZ-TMP, clindamycin and erythromycin; but lower resistance to fosfomycin, rifampicin, chloramphenicol and nitrofuran toin. No vancomycinor teicoplanin resistant strain of Staphylococcus spp. was identified. The resistance rate to penicillin, ampicillin, gentamicin, fosfomycin, chloramphenicol and ciprofloxacin was low in E. faecalis. E. faeciurn was relatively less resistant to tetracycline, fosfomycin and chloramphenicol. No vancomycinor teicoplanin resistant strain of Enterococcus spp. was found. About 41.3% of E. coli isolates and 36.5% of Klebsiella isolates produced extended-spectrum β-lactamases （ES BLs）. The resistance rates of ESBLs-producing strains to 19 antimicrobial agents were much higher than those of ESBLs nonproducing strains. No imipenem resistant isolate was found. The resistance rate of non-fermenters was lower to imipenem, cefoperazone sulbactam, piperacillin-tazobactam or ceftazidime. Conclusions No gram positive isolate is found resistant to glycopeptides. The resistance rate of gram negative bacilli was lower to imipenem, cefoperazone-sulbactam, or piperacillin-tazobactam. Surveillance of bacterial resistance is of great importance for rational use of antibiotics and reducing the emergence of resistance.

关 键 词：细菌 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]