安徽省104株黏质沙雷菌的分布及耐药性监测  

Distribution and resistance surveillance of 104 clinical strains of Serratia marcescens in Anhui Province

作　　者：程君[1] 杨海飞[1] 朱玉林[1] 胡立芬[1] 潘亚超[1] 刘艳艳[1] 叶英[2] 李家斌[1] 

机构地区：[1]安徽医科大学第一附属医院感染病科,合肥230022 [2]安徽省细菌耐药性监控中心,合肥230022

出　　处：《中华传染病杂志》2012年第9期524-528,共5页Chinese Journal of Infectious Diseases

基　　金：国家自然科学基金资助项目（3097263l,81101288）;安徽省自然科学基金资助项目（11040606Q23）

摘　　要：目的 探讨黏质沙雷菌感染的临床分布及耐药特点，为临床诊断和治疗提供依据。方法104株黏质沙雷菌药物敏感试验采用琼脂稀释法，结果依据临床实验室标准化委员会2010年推荐的标准。率的比较采用X^2检验。结果黏质沙雷菌在呼吸道痰标本中检出率最高（62株，59．6％），主要分布于呼吸内科（35株，33．7％）、ICU（24株，23．1％）、老年病科（17株，16．3％）。黏质沙雷菌对氨苄西林、庆大霉素、头孢唑啉的耐药率较高，分别为90．4％、86．5％、79．8％；对第三代头孢菌素的耐药率为24．0％～43．3％，未发现对亚胺培南、美罗培南耐药菌株。与头孢西丁耐药菌株比较，头孢西丁非耐药菌株对哌拉西林（82．9％比28．6％）、头孢他啶（63．4％比9．5％）、氨曲南（68．3％比9．5％）、阿米卡星（68．3％比20．6％）、环丙沙星（48．8％比19．1％）、氯霉素（90．3％比58．7％）等抗菌药物的耐药性明显降低（均P〈O．05）。结论黏质沙雷菌是目前医院感染重要的条件致病菌之一，对多种抗菌药物耐药，临床应加强对黏质沙雷菌耐药性的监控以防止耐药菌株的传播流行。analyze the clinical distribution and antimicrobial resistance profile of Serratia marcescens （S. marcescens）, and to provide the scientific evidence supporting clinical diagnosis and treatment. Methods The antimicrobial susceptibility test was performed in 104 strains of S. marcescens by agar dilution method. The results were judged according to the criteria recommended by Clinical and Laboratory Standards Institute （CLSI） 2010. The data were analyzed by chi square test. Results The majority of S. rnarcescens were isolated from sputum specimens, accounting for 59. 6% （62/104）. The bacteria were most frequently isolated from department of respiratory （33. 7%, 35/104）, followed by intensive care unit （23. 1%, 24/104）, department of gerontology （16. 30%, 17/104）. The results of antimicrobial susceptibility test showed that the resistance rates of S. rnarcescens against ampicillin, gentamicin and cephazolin were high, which were 90.4%, 86. 5% and 79.8%, respectively; those against the 3rd generation of eephalosporins were 24.0%-43. 30/00. No imipenem and meropenem cefoxitin-resistant strains, the resistance rates of resistant strains were identified. Compared with non-cefoxitin-resistant strains against piperacillin（82.9% vs 28. 6%）, cehazidime （63. 4% vs 9. 5%）, （68. 3% vs 9. 5%） （68.3% vs 20.6%）, eiprofloxacin （48.8% vs 19.1%） and chloramphenicol （90.3% vs 58 all lower （all P 〈0. 05）. Conclusions S. marcescens is one of the most common , amikacin 7 G ） were conditional pathogenic bacteria leading to nosocomial infections, which is resistant to many kinds of antimicrobial agents. The surveillance of antimicrobial resistance in S. marcescens should be strengthened for purpose of preventing the transmission of multidrug resistant strains.

关 键 词：沙雷菌属 微生物敏感性试验 抗药性 细菌 

分 类 号：R446.5[医药卫生—诊断学]