我院2008-2010年6983株临床分离细菌耐药性分析  

Drug resistance of 6 983 clinical strains isolated in our hospital from 2008 to 2010

作　　者：孟祥红[1] 董梅[1] 董月明[1] 孙敏霞[1] 何菊芳[1] 王迪[1] 

机构地区：[1]解放军第309医院检验科,北京100091

出　　处：《解放军医学院学报》2013年第2期104-106,109,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的了解2008-2010年我院住院和门诊患者分离到的细菌临床分布及耐药性,为临床合理用药提供依据。方法回顾性调查2008年1月-2010年12月我院分离到的6 983株细菌的临床分布及耐药性变迁。结果革兰氏阴性杆菌主要为铜绿假单胞菌、鲍曼/溶血不动杆菌、大肠埃希氏菌、肺炎克雷伯菌、嗜麦芽窄食单胞菌,铜绿假单胞菌居分离率首位;革兰氏阳性球菌主要为金黄色葡萄球菌、凝固酶阴性葡萄球菌、粪肠球菌和屎肠球菌;主要分布于重症监护病房、呼吸科、结核科、神经外科等病房。3年中大肠埃希菌产超广谱β-内酰胺酶(extended spectrum bete-lactamases,ESBLs)率为47.88%,肺炎克雷伯菌ESBLs率为38.0%,且呈逐年上升趋势,未发现耐亚胺培南的肠杆菌。鲍曼溶血/不动杆菌和铜绿假单胞对亚胺培南耐药率均超过50%。铜绿假单胞菌对派拉西林/他唑巴坦、阿米卡星和头孢他啶耐药率相对较低,但耐药率呈逐年上升趋势。鲍曼溶血/不动杆菌对多数抗菌素保持较高的耐药率。出现泛耐药鲍曼溶血/不动杆菌和铜绿假单胞菌株。耐甲氧西林金黄色葡萄球菌(methicillin resistant staphylococcus aureus,MRSA)总发生率为60.29%,耐甲氧西林凝固酶阴性葡萄球菌(MRSCoN)总发生率为83.43%,未发现耐万古霉素和利奈唑胺的葡萄球菌。肠球菌中粪肠球菌对于多数测试药物的耐药率较屎肠球菌低,分离出1株耐万古霉素屎肠球菌。结论 2008-2010年我院细菌耐药呈上升趋势,应加强病原菌耐药性监测。Objective To provide the evidence for the rational use of drugs by investigating the clinical distribution of 6 983 strains isolated in our hospital from 2008 to 2010 and their drug resistance.Methods The clinical distribution of 6 983 strains isolated in our hospital from 2008 to 2010 and their drug resistance were retrospectively analyzed.Results The mainly isolated Gram-negative bacteria were P.aeruginosa,A.baumannii,E.coli,K.pneumonia and S.maltophilia.The mainly isolated Gram-positive bacteria were staphylococcus aureus,coagulase negative staphylococcus,E.faecalis and E.faecium.The strains were mainly distributed in ICU,departments of respiratory diseases,tuberculosis and neurosurgery,etc.The 3-year ESBL rate of E.coli and K.pneumonia was 47.88% and 38.00%,respectively,and tended to increase yearly.No imipenem-resistant enterobacteriacea strains were found.The drug resistance rates of P.aeruginosa to A.mikacin and pipracillin-tazobatan were relatively low and tended to increase yearly.The drug resistance rates of A.baumannii and S.maltophilia to most antibiotics were relatively high.The total resistance rate of S.aureus strains and coagulase negative staphylococcus to methicillin was 60.29% and 83.43%,respectively.No vancomycin-and linezolidresistant staphylococcal strains were found.The drug resistance rate of E.faecalis strains was lower than that of E.faecium to most tested drugs.A vancomycin-resistant strain was isolated from E.faecium.Conclusion The drug resistance of strains isolated in our hospital from 2008 to 2010 tends to increase and its Monitoring should be strengthened.

关 键 词：细菌 耐药性 微生物敏感性试验 

分 类 号：R446.5[医药卫生—诊断学]