2010年医院细菌耐药性监测  

Surveillance of bacterial resistance in 2010

作　　者：俞北伟 章丽琴[1] 徐娇君[1] 金美珠 应华永[1] 

机构地区：[1]金华市人民医院检验科,浙江金华321000

出　　处：《中华医院感染学杂志》2012年第5期1029-1032,共4页Chinese Journal of Nosocomiology

基　　金：金华市科技局重点课题(2011-3-001)

摘　　要：目的了解医院2010年临床分离菌对各类抗菌药物的耐药性。方法采用纸片扩散法(K-B法)检测临床分离菌对各类抗菌药物的敏感性。结果临床分离1541株细菌中革兰阴性菌占73.5%,革兰阳性菌占26.5%,金黄色葡萄球菌和凝固酶阴性葡萄球菌中耐甲氧西林株分别占78.7%和86.2%,其耐药率显著高于甲氧西林敏感株,但仍有61.9%的MRSA对磺胺甲噁唑/甲氧苄啶敏感,87.0%的MRCNS对利福平敏感;肠球菌属中屎肠球菌的检出率为52.1%,首次高于粪肠球菌检出率的25.5%,未发现耐万古霉素、替考拉宁、利奈唑胺葡萄球菌和肠球菌,大肠埃希菌和克雷伯菌属细菌中产ESBLs株检出率分别为53.8%和43.1%,产ESBLs株的耐药率明显高于非产ESBLs株,未发现碳青霉烯类耐药株,不动杆菌属对头孢哌酮/舒巴坦较敏感,对亚胺培南、美罗培南的耐药率分别为52.4%、60.2%;铜绿假单胞菌对两者的耐药率分别为9.6%、9.1%;米诺环素对嗜麦芽寡养单胞菌和洋葱伯克霍尔德菌有良好的抗菌活性,敏感率均>95.0%;出现7株泛耐药的铜绿单胞菌和5株泛耐药鲍氏不动杆菌。结论凝固酶阴性葡萄球菌中甲氧西林耐药株的检出率高,不动杆菌属对两种碳青霉烯类药物的耐药率均>50.0%,并出现部分泛耐药鲍氏不动杆菌和铜绿假单胞菌,应引起重视,及早采取预防控制措施。OBJECTIVE To investigate the drug resistance of clinical isolates to various antibiotics in 2010.METHODS Antibiotic susceptibility testing was carried out by K-B method.RESULTS Of 1541 clinical isolates,gram-negative bacteria and gram-positive bacteria accounted for 73.5% and 26.5%,respectively.Methicillin-resistant Staphylococcus aureus（MRSA） and coagulase-negative Staphylococcus（MRCNS） accounted for 78.7% and 86.2%,respectively.The resistance rates of methicillin-resistant isolates were much higher than those of methicillin-susceptible isolates.However,about 61.9% of MRSA strains were still susceptible to sulfamethoxazole/trimethoprim and 87.0% of MRCNS strains were still susceptible to rifampin.In Enterococcus spp,the detection rate of E.faecium（52.1%） was higher,for the first time,than that of E.faecalis（25.5%）.No vancomycin,teicoplanin or linezolid-resistant Staphylococcus isolates or Enterococcus isolates were found.The detection rates of ESBLs-producing Escherichia coli and Klebsiella spp isolates were 53.8% and 43.1%,respectively,and the resistance rates of ESBLs-producing isolates were significantly higher than those of non-ESBLs-producing isolates.No carbapenems-resistant strains were found.Acinetobacter spp.were still highly susceptible to cefoperazone/sulbactam,and the resistance rates to imipinem and meropinem were 52.4% and 60.2%,respectively;the resistance rates of Pseudomonas aeruginosa isolates to imipenem and meropenem were 9.6% and 9.1%,respectively.Minocycline had good antibiotic activity against S.maltophilia and Burkholderia spp with both of the susceptibility rates more than 95.0%.Seven strains of pan-drug resistant P.aeruginosa and 5 strains of pan-drug resistant Acinetobacter baunmnnii were found.CONCLUSION The detection rate of MRCNS in methicillin-resistant isolates is high.The resistance rates of Acinetobacter spp to two carbapenems drugs are both higher than 50.0%,and pan-drug resistant A.baumannii and P.aeruginosa have emerged.Therefore,early prevention measures shoul

关 键 词：细菌耐药性监测 药敏试验 泛耐药 超广谱Β-内酰胺酶 耐甲氧西林葡萄球菌属 

分 类 号：R378[医药卫生—病原生物学]