2007年细菌耐药监测结果分析  

Analysis on antimicrobial resistance surveillance results in 2007

作　　者：张智洁[1] 刘勇[1] 孙继梅[1] 王艳玲[1] 王晓宇[1] 

机构地区：[1]中国医科大学附属盛京医院

出　　处：《中国感染控制杂志》2009年第1期36-40,共5页Chinese Journal of Infection Control

摘　　要：目的总结和分析某医院2007年细菌耐药监测资料。方法采用API系统鉴定细菌到种，以纸片扩散法进行药敏试验（按照美国临床实验室标准化研究所2007年标准），药敏结果以WHONET5．4软件进行统计分析。结果全年共分离3107株细菌，革兰阴性菌占60．93％，革兰阳性菌占27．78％，真菌占11．30％。耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的60．58％和77．35％。屎肠球菌的分离数和耐药率均高于粪肠球菌（P〈0．（15），氨基糖苷类高度耐药肠球菌的产生率为59．44％。大肠埃希菌和克雷伯菌属超广谱β-内酰胺酶产生率分别为59．50％和55．98％。63．97％的铜绿假单胞菌来源于痰标本，不同科室痰标本中分离的铜绿假单胞菌耐药率从高到低依次为重症监护室（21．05％）、神经外科（15．99％）、呼吸急救儿科（7．09％）、呼吸内科（6．07％）。结论定期总结医院细菌耐药监测结果，发现细菌呈多重耐药趋势，对规范医生合理使用抗菌药物具有重大意义。Objective To analyze the data of antimicrobial resistance surveillance in a hospital in 2007. Methods Bacterial isolates were identified by API system, antimicrobial susceptibility tests were performed by Kirby-Bauer method and analyzed by WHONET5.4 software. Results A total of 3 107 clinical isolates were isolated in 2007, 60.93 % were gram-negative bacteria, 27.78 % were gram-positive bacteria and 11.30 % were fungi. 60.58 % of Staphylococcus aureus was methicillin-resistant Staphylococcus aureus （MRSA） and 77.35% of coagulase negative Staphylococcus was methicillimresistant coagulase negative Staphylococcus （MRCNS） respectively. The prevalence and drug-resistance of Enteroeoccus faecium were higher than Enterococcus faecali （P〈0. 05） , the preva lence of high-level aminoglycosides-resistant Enterococcus Was 59.44 %. The prevalence of extended-spectrum betalactamase of Escherichia coli and Klebsilla spp. was 59. 50% and 55.98%, respectively. 63. 97% of Pseudo monas aeruginosa were isolated from sputum, drug resistant rate of Pseudomonas aeruginosa in sputum from patients in ICU, neurosurgical department, respiratory and emergency pediatric department, respiratory department was 21.05%, 15.99% ,7. 09% and 6. 07% respectively. Conclusion Periodical summarization of antimicrobial resistance surveillance results and discovery of drug resistance trends is great significant for guiding rational antimicrobial therapy.

关 键 词：细菌 抗菌药物 抗药性 微生物 监测 合理用药 

分 类 号：R969.3[医药卫生—药理学]