2007年南京医科大学第一附属医院细菌耐药性监测  

Surveillance of resistance antibiotic in clinical isolates from First Affiliated Hospital of Nanjing Medical University in 2007

作　　者：梅亚宁[1] 顾兵[1] 文怡[1] 陈友华[1] 王珏[1] 

机构地区：[1]南京医科大学第一附属医院,南京210029

出　　处：《中国抗生素杂志》2009年第4期245-250,共6页Chinese Journal of Antibiotics

摘　　要：目的了解2007年南京医科大学第一附属医院临床分离常见病原菌对常用抗菌药物耐药现状。方法采用纸片扩散法进行抗菌药物敏感性试验,按CLSI 2007年标准判定药敏结果,以WHONET5.4软件分析数据。结果2007年我院共分离细菌4408株菌,其中革兰阳性菌1154株(26.3%),革兰阴性菌2829株(64.2%);前10位病原菌依次为大肠埃希菌(19.4%),铜绿假单胞菌(17.9%),凝固酶阴性葡萄球菌(11.5%),肺炎克伯雷菌(10.4%),白念珠菌及其它酵母(9.1%),金葡菌(6.7%),鲍曼不动杆菌(5.9%),肠球菌(4.2%),肠杆菌属菌(4.1%)和链球菌(3.4%)。MRSA和MRCNS的检出率分别为30.8%和33.0%。未检出万古霉素和替考拉宁耐药的葡萄球菌,但检测到2株对万古霉素、替考拉宁均耐药的粪肠球菌和2株对万古霉素、替考拉宁均耐药的屎肠球菌;大肠埃希菌、克雷伯菌中产ESBLs检出率分别为32.8%、22.6%;分离到21株(2.7%)泛耐药的铜绿假单胞菌(只对多黏菌素敏感)和17株(6.5%)泛耐药的鲍曼不动杆菌。结论我院细菌耐药状况较为严重,进行细菌耐药性监测有助于了解我院细菌耐药性变迁,为临床经验用药提供理论依据。Objective To investigate the resistance of clinical isolates to antimicrobial agents commonly used in First Affiliated Hospital of Nanjing Medical University during 2007. Methods Disk diffusion susceptibility test was used to determine the antimicrobial susceptibility. Results were analyzed by WHONETS. 4 software according to CLSI guidelines （2007）. Results Of the 4408 clinical isolates, 26.2% （1154/4408） were Gram positive cocci and 64. 2% （2829/4408） were Gram negative bacilli .The top ten pathogens were E. coli（19, g% ）, P. aeruginosa （17.9%）, coagulase negative Staphylococci （11.5%）, Klebsiella Pneumoniae （10.4%）, C. albicans（9. 1% ）, S. aureus（6.7% ）, Acinetobacter spp （5.9%）, Enterococcus （4. 2% ）, Enterobacter （4. 1% ） and Streptococcus （3.4%）; The prevalence of methicillin-resistant starpbylococci （MRS） was identified in 30.8% of S. aureus isolates and 33.0% of coagulase negative Staphylococci. None of Staphylococci isolate was found resistant to vancomycin or teicoplanin. Two strains of E.faecalis and two strains of E.faecium were resistant to vancomycin or teicoplanin. ESBLs were produced in 32.8 % of E. coli and 22. 6%of ICpneumoniae. About 2.7% （21/789） of P. aeruginosa and 6.5% （17/260） of A. baumannii isolates were panresistant strains （only sensitive to colistin）. Conclusions Antimicrobial resistance in clinical bacterial isolates was a very serious problem in our hospital. Surveillance of bacterial resistance was important and valuable for understanding the trend of antimicrobial resistance and rational antimicrobial therapy.

关 键 词：细菌耐药性监测 抗菌药物 革兰阳性球菌 革兰阴性杆菌 

分 类 号：R378[医药卫生—病原生物学]