2010年昆明地区细菌耐药性监测及分析  

Surveillance and analysis of bacterial resistance of clinical isolates in Kunming during the year 2010

作　　者：刘晓莉[1] 黄云昆 单斌[3] 李丰良[4] 周林[5] 胡莹[1] 

机构地区：[1]昆明医学院第二附属医院检验科,云南昆明650101 [2]昆明市延安医院检验科 [3]昆明医学院第一附属医院检验科 [4]云南省第一人民医院检验科 [5]昆明市第一人民医院检验科

出　　处：《实验与检验医学》2011年第2期113-116,共4页Experimental and Laboratory Medicine

摘　　要：目的了解2010年昆明地区常见细菌的分布和耐药性。方法对2010年云南省昆明地区5家三甲医院临床标本中分离的常见细菌,采用纸片扩散法(K-B法)进行药敏试验。以CLSI2010年版为判断标准,数据分析采用WHONET 5.4软件。结果在临床分离的9226株细菌中,革兰阳性菌占37.8%,革兰阴性菌占62.2%,革兰阴性杆菌感染中铜绿假单胞菌和不动杆菌上升明显。药敏试验结果显示:MRSA检出率为86.2%,MRCNS检出率为58.6%,MRCNS对替考拉宁耐药率达到1.8%。大肠埃希菌、克雷伯菌属和奇异变形杆菌中产ESBLs检出率分别为58.9%、49.6%和13.8%,出现亚胺培南耐药的肠杆菌科细菌。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为54%和35.7%。不动杆菌属对亚胺培南和美罗培南的耐药率分别为19.2%和25.5%。嗜麦芽窄食单胞菌对左氧氟沙星和复方磺胺甲噁唑耐药率分别为29.7%和42.7%,尚未发现米诺环素耐药的嗜麦芽窄食单胞菌。出现少数铜绿假单胞菌对现用抗菌药(除多黏菌素外)均耐药的泛耐药株。结论昆明地区细菌耐药性仍呈上升趋势,已经出现对亚胺培南耐药的肠杆菌科细菌和泛耐药铜绿假单胞菌,应引起重视。加强细菌耐药监测对控制耐药菌在医院暴发流行极为重要。Objective To investigate the bacterial resistance profile of clinical isolates in Kunming.Methods The antimicrobial susceptibility of clinical isolates was tested by Kirby-Bauer method.The results were analyzed according to CLSI criteria 2010.The susceptibility data were analyzed using Whonet 5.4 software.Results Of the 9266 clinical isolates from five hospitals,gram positive cocci and gram negative bacilli were accounted for 37.8% and 62.2% respectively.The rates of infection caused by the P.aeruginosa and A.baumanii increased significantly in 2010 compared to those in previous years.The results of antibiotic resistance showed that the prevalence of MRSA in S.aureus and MRCNS in coagulase negative Staphylococcus was 86.2% and 58.6%,respectively.Resistant rate of MRCNS against teicoplanin was 1.8%.The prevalence of ESBLs-producing strains was 58.9% in E.coli,and with 49.6% or 13.8% of Klebsiella spp or P.mirabilis.Some imipenem resistant isolates were identified in Enterobacteriaceae.The drug resistant rates of P.aeruginosa isolates showed 54.0% and 35.7% to imipenem and meropenem respectively.About 19.2% of Acinetobacter isolates was resistant to imipenem.The resistance rates of S.maltophilia to fluoroquinolones and Trimethoprim-sulamethoxazole were 29.7% and 42.7% respectively.No minocycline-resistant S.matophilia was found.Conclusions Bacterial resistance is still on the rise in Kunming crowd.A few strains of imipenem resistant isolates have been identified in Enterobacteriaceae and pan-resistant P.aeruginosa.It is important to strengthen the surveillance of bacterial resistance to control the transmission of cloning strains in the hospita1.

关 键 词：耐药性监测 抗菌药物 药敏试验 

分 类 号：R446.5[医药卫生—诊断学] Q939.92[医药卫生—临床医学]