2010年湘雅医院细菌耐药性监测  

2010 surveillance of bacterial resistance in Xiangya hospital

作　　者：邹明祥[1] 李军[1] 邬靖敏[1] 梁伟[1] 张宁洁[1] 李虹玲[1] 刘文恩[1] 

机构地区：[1]中南大学湘雅医院检验科,湖南长沙410008

出　　处：《中国现代医学杂志》2012年第10期33-37,共5页China Journal of Modern Medicine

基　　金：湖南省自然科学基金(No:10JJ5027);中南大学本科生自由探索研究创新基金(No:2010112001166)

摘　　要：目的了解2010年1月1日～12月31日中南大学湘雅医院临床常见分离病原菌的分布及耐药性。方法采用Vitek 2对临床常见分离病原菌进行鉴定及药敏试验,按CLSI 2010版标准判断结果。用WHONET5.4软件对实验结果进行分析。结果 2010年临床分离的5 011株病原菌中,革兰阳性菌为1 417株,占28.3%,革兰阴性菌为2 684株,占53.6%,真菌910株,占18.2%。金黄色葡萄球菌和凝固酶阴性葡萄球菌中耐甲氧西林菌株的分离率分别为60.4%(142/235)和55.6%(262/471)。未出现对万古霉素、利奈唑胺和替考拉宁耐药的葡萄球菌,分离到3株对万古霉素耐药的屎肠球菌。大肠埃希菌和肺炎克雷伯菌产ESBLs的检出率分别为77.6%(470/606)和58.4%(211/361),肠杆菌科细菌对头孢哌酮/舒巴坦和碳青霉烯类仍具有较高的敏感性,耐药率分别为0.9%～15.8%和0.5%～10.1%。铜绿假单胞菌对亚胺培南和美洛培南的耐药率分别为15.8%和17.3%,鲍曼不动杆菌对亚胺培南和美洛培南的耐药率分别为49.4%和29.7%。发现几株泛耐药菌株,其中铜绿假单胞菌3株,不动杆菌属3株。结论该院临床分离病原菌耐药状况较为严重,应加强细菌耐药监测,密切关注其耐药性变迁,为临床经验用药提供实验依据。【Objective】 To investigate the distribution and antibiotic resistance of clinical isolates collected from Xiangya Hospital of Central South University from January 1 to December 31,2010.【Methods】 Identification of isolates and antimicrobial susceptibility test was carried out by Vitek 2 system and data were analyzed by WHONET 5.4 software according to CLSI 2010 standards.【Results】 A total of 5 011 isolates were collected,in which gram negative bacteria,gram positive bacteria and fungus accounted for 53.5%（2 684/5 011）,28.3%（1 417/5 011） and 18.2%（910/5 011）,respectively.Methicillin resistant Staphylococcus aureus（MRSA） and coagulase-negative Staphylococcus（MRCNS） accounted for 60.4%（142/235） and 55.6%（262/409）,respectively.No vancomycin,linezolid or teicoplanin resistant Staphylococcus was found,but 3 vancomycin resistant Enterococcus faecium were isolated.Extended Spectrum Beta-Lactamases（ESBLs）-producing strains accounted for 77.6%（470/606） of Escherichia coli and 58.4%（211/361） of Klebsiella pneumoniae.Enterobacteriaceae remained highly sensitive to cefoperazone/ sulbactam and carbapenem,and the resistance rates were 0.9%～15.8% and 0.5%～10.1%,respectively.Resistance rates of pseudomonas aeruginosa to imipenem and meropenem were 15.8% and 17.3%,respectively.Resistance rates of acinetobacter baumannii to imipenem and meropenem were 49.4% and 29.7%.A few pan-drug resistant strains of P.aeruginosa and acinetobacter spp.were isolated.【Conclusions】 Drug resistance of clinical isolates is severe in this hospital.Therefore,we should strengthen the surveillance of antimicrobial resistance and pay more attention to the changes of antimicrobial resistance in order to provide laboratory basis for rational selection of antimicrobial agents.

关 键 词：细菌耐药性 抗菌药物 药敏试验 泛耐药菌 

分 类 号：R446[医药卫生—诊断学]