2012年济南市中心医院细菌耐药性监测  

Surveillance of Bacterial Resistance in Jinan Central Hospital in 2012

作　　者：初晶学[1] 裴凤艳[1] 张芳[1] 

机构地区：[1]济南市中心医院,山东济南250013

出　　处：《中国医学创新》2013年第26期134-138,共5页Medical Innovation of China

摘　　要：目的:了解山东省济南市中心医院2012年临床分离菌对常见抗菌药物的耐药情况。方法:采用纸片扩散法(K-B法)和E-test法进行药敏试验,采用美国临床和实验室标准协会(CLSI)2012版标准判断结果。结果:临床分离细菌1641株,革兰阳性菌为480株(29.3%),革兰阴性菌为1161株(70.7%)。MRSA和MRSCNS检出率分别为47.0%(133/283)和69.8%(37/53)。未发现对万古霉素、利奈唑胺耐药的葡萄球菌。32株肺炎链球菌中,全部来自非脑脊液标本。仅一株分离自儿童患者的细胞株对青霉素耐药(PRSP),其余均为敏感。肠杆菌科细菌中产ESBLs大肠埃希菌和肺炎克雷伯菌的检出率分别为60.5%和44.7%,仅有两株肺炎克雷伯菌对亚胺培南和美罗培南耐药(1.3%)。铜绿假单胞菌仅对氨曲南、亚胺培南、替卡西林/克拉维酸耐药率超过30%。鲍曼不动杆菌仅对米诺环素(29.5%)、头孢哌酮/舒巴坦(30.3%)的耐药率稍低,对其他抗菌药物耐药率均超过45%。嗜麦芽窄食单胞菌对左氧氟沙星、米诺环素、甲氧苄啶-磺胺甲噁唑耐药率分别为11.4%、1.2%、2.2%。流感嗜血杆菌β内酰胺酶检出率为54.3%。结论:细菌对抗感染药物的耐药现状形势严峻,定期进行细菌耐药性监测有助于了解医院和本地区细菌及其耐药性变迁,为临床经验用药和合理用药提供依据。Objective：To investigate the resistance of clinical isolate collected from the Jinan Central Hospital in 2012.Method：Antimicrobial susceptibility testing was conducted according to an agreed protocal using Kirby-Bauer（K-B）method.Results were analyzed according to the breakpoints of CLSI 2012.Result：Of the 1641 clinical isolates,gram positive strains and gram negative strains accounted for 29.3% and 70.7% respectively.The prevalence of methicillin-resistant strains was 47.0% in S.aureus（MRSA）and 69.8% in coagulase-negtive Staphylococcus（MRCNS）.No staphylococcus strain was found resistant to vancomycin or linezolid.No strains of streptococcus pneumoniae were isolated from meningitis.Only one penicillin-resistant S.pneumoniae（PRSP）was isolated from children.The other isolates were penicillin-susceptible S.pneumoniae（PRSP）.ESBLs were produced in 60.5% of the E.coli strains,44.7% of the K.pneumoniae.Enterobacteriaceae strains were still very sensitive to carbapenem antibiotics,except two K.pneumoniae strains were resistant to carbapenem antibiotics.More than 30% P.aeruginosa isolates strains were only resistant to ticarcillin-clavulanate,aztreonam,imipenem.More than 45% Acinetobacter baumannii strains were resistanted to all antimicrobials except minocycline and cefoperazone-sulbactam.Stenotrophomonas maltophilia strains were relatively susceptible to sulfamethoxazole-trimethoprim,minocycline,levofloxacin with lower resistance rate.There were 54.3% H.influenzae which produced β-lactamase.Conclusion：We are facing a more serious situation of bacterial resistance.Periodic surveillance of bacteria resistance is most important and valuable for antimicrobial therapy.

关 键 词：细菌耐药性 抗菌药物 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]