2007年安徽省细菌耐药性监测  

Surveillance of antimicrobial agents resistance in Anhui province in 2007

作　　者：孙震[1] 程君[1] 殷俊[1] 高伟[1] 叶英[1] 李家斌[1,2] 

机构地区：[1]安徽医科大学第一附属医院感染病科,合肥230022 [2]安徽省细菌耐药性监测中心,合肥230022

出　　处：《安徽医科大学学报》2009年第2期224-228,共5页Acta Universitatis Medicinalis Anhui

基　　金：国家自然科学基金项目(编号:30571654、30772286);安徽省自然科学基金项目(编号:070413110)

摘　　要：目的了解2007年安徽省临床分离菌株的耐药状况。方法采用琼脂稀释法对从安徽省33家医院分离的1437株临床分离的细菌进行体外药敏试验,测定细菌的最低抑菌浓度(MIC),并按照美国临床实验室标准委员会(CLSI)2007年版标准,计算细菌对抗菌药物的敏感率(S%)、中介率(I%)、耐药率(R%)。结果1437株临床分离株中,革兰阳性菌占25.3%(364/1437),革兰阴性菌占74.7%(1073/1437)。在革兰阳性细菌中,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为56%(56/100),耐甲氧西林表皮葡萄球菌(MRSE)检出率为95.8%(69/72),未发现耐糖肽类的葡萄球菌。革兰阴性菌中,大肠埃希菌和肺炎克雷伯菌分别占33%(354/1073)和16.8%(180/1073),大肠埃希菌和肺炎克雷伯菌中产ESBLs菌株检出率分别为47.2%和40%。革兰阴性菌对哌拉西林/他唑巴坦的敏感率明显高于所有头孢类抗菌药物;碳青霉烯类抗菌药物对革兰阴性菌的抗菌活性最强。结论安徽省临床分离的细菌耐药性日趋严重,临床上应合理应用抗菌药物,并加强细菌耐药性监测,以防止细菌耐药性的蔓延。Objective To investigate the surveillance data on antimicrobial agents resistance in Anhui province reported in 2007. Methods Antimicrobial susceptibility test was performed to detect the minimal inhibitory concentration （MIC） of 1 437 clinical non-repeated isolates collected from 33 hospitals in Anhui province according to Clinical and Laboratory Standard Institute （CLSI） guidelines 2007, and data of R （ resistance ） %, I （ intermediate） % and S （susceptible） % of bacteria to antimicrobial agents, respectively. Results Among total 1 437 clinical strains, gram positive organisms and gram negative organisms accounted for 25.3% （364/1 437 ） and 74.7% （ 1 073/1 437）, respectively. Among gram positive cocci, the detection rates of MRSA and MRSE were 56% （56/ 100） in Staphylococcus aureus and 95.8 % （69/72） in Coagulase negative Staphylococcus epidermidis, respectively. No strains of gram positive Cocci had resistance to glycoptide antimicrobial agents. Escherichia coli and K. pneumoniae accounted for 33% （354/1 073） and 16.8% （ 180/1 073）, respectively. Extended-spectrum beta-lactamases （ESBLs） were produced in 47.2% of E. coli and 40% of K. pneumoniae isolates, respectively. Susceptible rates of gram negative bacteria to piperacillin-tazobactam were higher than other cephalosporins. Carbopenems were the most potent antimicrobial agents against gram negative bacilli. Conclusion Antimicrobial agents resistance in clinical bacterial isolates is a serious problem in Anhui province. In order to control bacterial resistance, choosing antimicrobial agents reasonably in the treatment of bacterial infections and reinforcing surveillance of bacterial resistance are urgently needed.

关 键 词：抗药性 细菌 

分 类 号：R96[医药卫生—药理学] R37[医药卫生—药学]