四川省细菌耐药监测网2011年川西地区细菌耐药性监测数据分析  

Sichuan Provincial of antimicrobial Resistant Investigation Net 2011 annual report:Bacterial drug resistance surveillance in West Sichuan

作　　者：杨莉莉[1] 刘华伟[1] 刘敏[1] 邓瑛[1] 张俊梅[1] 段婉芸[1] 冯小艳[1] 

机构地区：[1]成都市第三人民医院检验科,四川成都610031

出　　处：《实用医院临床杂志》2012年第6期110-115,共6页Practical Journal of Clinical Medicine

摘　　要：目的总结分析川西地区6个市(州)17家医院2011年度临床分离病原菌的分布及对抗菌药物的耐药性。方法采用K-B法或自动化仪器分析法对临床分离细菌进行药物敏感试验,依据CLSI 2010年标准,采用WHO-NET5.4软件进行统计分析。结果共分离出病原菌株20079株,其中革兰阴性菌14454株,占分离菌的71.99%;革兰阳性菌5625株,占分离菌的28.01%。前10位病原菌依次为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌、鲍曼不动杆菌、表皮葡萄球菌、阴沟肠杆菌、肺炎链球菌、屎肠球菌、流感嗜血杆菌。肠杆菌科细菌对亚胺培南仍保持较高的敏感率(>93.0%)。未检测到万古霉素及利奈唑胺耐药的葡萄球菌。粪肠球菌对替考拉宁和万古霉素耐药率分别为1.30%和0.70%,屎肠球菌为5.40%和4.00%。结论产超光谱β内酰胺酶的发酵菌及多重耐药的铜绿假单胞菌和鲍曼不动杆菌呈逐年上升趋势。耐甲氧西林葡萄球菌(MRS)和耐糖肽类的肠球菌是抗菌药物治疗中的难点。临床应根据细菌的耐药表型和药敏试验结果合理选用抗菌药物。Objective To summarize the drug resistance of clinical isolates in western sichuan of china with 17 hospitals in 2011. Methods Isolates were cultured by routine methods and identified by the semi-automatic or automatic bacteria analysis system. Drug susceptibility test was according to CLSI standards. Data statistic and analysis used WHONETS. 4 software. Results 20079 strains were isolated, which included 14454 （71.99%） Gram-negative strains, and 5625 （28.01% ） Gram-positive strains. The top ten pathogens were E. coli, K. pneumonia, P. aeruginosa, S. aureus,A, baumannii, S. epidermidis, E. faecalis, S. pne, E. faecium and H. influ. No linezolid-resistant Staphylococcus strains was found. The drug resistant rates of Enterococcus faecalis to teicoplanin and vancomycin were 1.30% and O. 70%, Enterococcus faecium were 5.40% and 4.00% respectively. Conclusion ESBLs-produ- cing Enterobacteriaceae and the multiple drug-resistant bacteria fermentation of pseudomonas aeruginosa and acinetobacter baumannii were increasing year by year. MRS and glycopeptides resistant Enterococcus were the difficult points of Antibacterial drug therapy. Therefore, reasonable choice of antimicrobial agents should be based on the bacterial resistant drug phenotype detection and drug sus- ceptibility test results against bacteria infection.

关 键 词：细菌 耐药 革兰阴性菌 革兰阳性菌 药敏试验 

分 类 号：R370[医药卫生—病原生物学] R962[医药卫生—基础医学]