2008年蚌埠医学院第一附属医院病原菌耐药性监测  

Surveillance of antibiotic resistance in clinical isolates from the first affiliated hospital of Bengbu Medical College during 2008

作　　者：张永[1] 李峰[1] 胡俊锋[1] 宫蓓蕾[1] 陈余清[1] 

机构地区：[1]蚌埠医学院第一附属医院安徽呼吸系病临床基础省级实验室,蚌埠233000

出　　处：《中国抗生素杂志》2010年第12期924-929,共6页Chinese Journal of Antibiotics

基　　金：安徽省临床医学应用技术项目(2008A039)

摘　　要：目的了解我院2008年临床分离细菌对抗菌药物的耐药性。方法使用纸片扩散法及MIC测定,按照CLSI(2008)标准判读细菌药敏结果。结果临床分离细菌1723株,其中革兰阴性细菌1212株(70.3%)。金黄色葡萄球菌和凝固酶阴性葡萄球菌中耐甲氧西林分别占42.5%和77.1%;粪肠球菌对氨苄西林/舒巴坦和庆大霉素的耐药率分别为43.5%和69.6%,而屎肠球菌分别为89.5%和84.2%,未发现万古霉素及利奈唑胺耐药株。肠杆菌科细菌对亚胺培南敏感率92%以上,其次对阿米卡星、哌拉西林/三唑巴坦敏感性较高。不动杆菌多重耐药情况严重,对亚胺培南耐药率高达64.8%,泛耐药株占29.6%;铜绿假单胞菌对碳青霉烯类亚胺培南耐药率为23.2%。2008年分离出真菌351株,其中白色念珠菌占53.6%。真菌对临床常用抗真菌药物敏感性较高,对两性霉素B、伏立康唑敏感性最高。结论我院2008年临床分离细菌临床耐药性十分严重,其中以不动杆菌、表皮葡萄球菌尤其值得关注。提倡加强耐药性监测和合理使用抗菌药物。Objective To investigate the resistance of clinical isolates from the first Affiliated Hospital of Bengbu Medical College during 2008.Methods Bacterial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or alternatively determined by Minimum inhibitory concentration（MIC） method,and interpreted as recommended by CLSI（2008）.Results Totally 1723 nonduplicate isolates were collected,1212（70.3%） of which were Gram negative bacteria.42.5% and 77.1% Staphylococcus aureus and coagulase negative staphylococci were methicillin-resistant respectively.43.5% and 69.6% Enterococcus faecalis were resistant to ampicillin-sulbactam and Gentamycin respectively,while the ratios of Enterococcus faecium were 89.5% and 84.2%.No Vancomycin and Linezolid resistance were detected among these isolates.Enterococcus spp.were less susceptible to commonly used antimicrobial agents,except imipenem,with the highest susceptibility（over 92%）,Amikacin and Piperacillin-Tazobactam.Acinetobacter spp.was the most resistant isolates found,with imipenem resistant and pan-drug resistant rate of 64.8% and 29.6% respectively.23.2% of Pseudomonas aeruginosa isolates were resistant to imipenem.351 strains of fungi were isolated in 2008,with Candida albicans accounted for 53.6%.Most of the fungi isolates remained sensitive to commonly used antifungal agents,of which amphotericin B and voriconazole were of the highest sensitivity.Conclusion The resistance to antimicrobial agents of the isolates in our hospital during 2008 was very serious.Acinetobacter spp.and Staphylococcus epidermidis are among the most resistant bacteria of particular concern.It is advocatable to strengthen the surveillance of antimicrobial susceptibility and rational use of antimicrobial agents.

关 键 词：细菌 真菌 微生物敏感性试验 耐药 微生物 

分 类 号：R378[医药卫生—病原生物学]