2009年广东省东莞市太平人民医院细菌耐药监测  

Surveillance of antimicrobial resistance in clinical isolates from Dongguan Taiping People's Hospital in 2009

作　　者：李明[1] 周湧[1] 吴润转[1] 郭文婷[1] 邹裕[1] 

机构地区：[1]广东省东莞市太平人民医院检验科,523907

出　　处：《中国感染与化疗杂志》2011年第5期358-363,共6页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解广东省东莞市太平人民医院2009年临床分离菌对常用抗菌药物的耐药情况。方法采用纸片扩散法(K-B法)进行抗菌药物药敏试验,采用CLSI 2009年版判断标准,数据分析采用WHONET 5.4软件。结果临床分离的1331株细菌中,革兰阴性菌占70.8%(943/1331),革兰阳性菌占29.2%(388/1 331)。金葡菌和凝固酶阴性葡萄球菌分别为152株和123株,其中MRSA和MRCNS的检出率分别为27.6%和80.5%,未检出糖肽类抗生素耐药的革兰阳性球菌。肠杆菌科细菌对亚胺培南、美罗培南高度敏感,产ESBLs的大肠埃希菌和肺炎克雷伯菌的检出率分别为47.4%(154/325)和38.5%(74/192)。检出1株耐碳青霉烯类抗生素的阴沟肠杆菌。鲍曼不动杆菌对亚胺培南、美罗培南、头孢哌酮-舒巴坦和哌拉西林他唑巴坦的耐药率均低于20%。铜绿假单胞菌对亚胺培南、美罗培南、阿米卡星、头孢哌酮-舒巴坦和哌拉西林他唑巴坦的耐药率均低于10%。嗜麦芽窄食单胞菌对磺胺甲(口恶)唑-甲氧苄啶、左氧氟沙星和米诺环素的耐药率较低。结论 2009年该院临床分离菌以革兰阴性杆菌为主,所分离的革兰阴性杆菌对碳青霉烯类抗生素高度敏感,但已检出1株耐碳青霉烯类抗生素的阴沟肠杆菌。开展细菌耐药监测,对指导本单位合理应用抗菌药物有重要意义。Objective To investigate the resistance of clinical isolates to antimicrobial agents commonly used in Taiping People＇s Hospital,Dongguan during 2009.Methods Disk diffusion susceptibility test was used to determine the antimicrobial susceptibility. The data were analyzed by WHONET 5.4 software according to CLSI 2009 breakpoints.Results Of the 1 331 clinical isolates,gram negative bacilli and gram positive cocci accounted for 70.8%（943/1 331） and 29.2%（388/1 331）,respectively. About 27.6%of 152 S.aureus isolates were identified as MRSA,and 80.5%of 123 coagulase negative Staphylococcus isolates were identified as MRCNS.No strain of gram-positive cocci was found resistant to glycopeptides.Isolates of Enterobacteriaceae were highly sensitive to carbapenem.ESBLs-producing strains accounted for 47.4%（154/325） in E.coli and 38.5% （74/192） in K.pneumoniae.One carbapenem-resistant strain of Enterobacter cloacae was found.Not more than 20%of A. baumannii were resistant to imipenem,meropenem,cefoperazone-sulbactam,or piperacillin-tazobactam.Not more than 10% of P.aeruginosa were resistant to imipenem,meropenem,amikacin,cefoperazone-sulbactam,or piperacillin-tazobactam. Stenotrophomonas maltophilia was relatively susceptible to sulfamethoxazole -trimethoprim,levofloxacin,minocycline with lower resistance rate.Conclusions Gram-negative bacilli were dominant isolates in our hospital during 2009.Isolates of gramnegative bacilli were highly sensitive to carbapenem,but carbapenem-resistant strain in Enterobacteriaceae was emerging.Surveillance of antimicrobial resistance is very important for guiding reasonable use of antimicrobial agents.

关 键 词：药敏试验 细菌耐药性监测 耐甲氧西林金黄色葡萄球菌 超广谱Β内酰胺酶 

分 类 号：R446.5[医药卫生—诊断学]