安徽省铜陵地区2011年细菌耐药性监测  

Surveillance of bacterial resistance in Anhui Tongling area during 2011

作　　者：沈智勇[1] 宋有良[1] 王谦[1] 潘晓龙[2] 周东升[2] 黄丽 钱泽平 刘三保[5] 陈自武[6] 朱向阳[7] 

机构地区：[1]安徽省铜陵市人民医院感染科,安徽铜陵244009 [2]安徽省铜陵市人民医院检验科,安徽铜陵244009 [3]铜陵有色职工总医院 [4]铜陵市第四人民医院 [5]安徽省铜陵市第二人民医院 [6]安徽省铜陵市中医院 [7]安徽省铜陵县人民医院

出　　处：《中国感染与化疗杂志》2013年第6期450-455,共6页Chinese Journal of Infection and Chemotherapy

基　　金：安徽省临床医学应用技术项目经费资助课题(2008A058)

摘　　要：目的了解安徽省铜陵地区临床分离菌株耐药状况。方法用Kirby-Bauer法进行药敏试验,用WHONET5.5软件进行耐药性分析。结果 2011年共收集非重复临床分离菌2 690株,其中革兰阴性菌1 995株,占74.2%,革兰阳性菌695株,占25.8%。MRSA和MRCNS分别占金葡菌和凝固酶阴性葡萄球菌的45.1%和71.6%;MRSA和MRCNS对β内酰胺类抗生素耐药,对庆大霉素、环丙沙星和红霉素等均高度耐药,未见耐万古霉素和替考拉宁葡萄球菌属。粪肠球菌对青霉素、呋喃妥因和磷霉素的耐药率较低,未见耐氨苄西林、万古霉素和替考拉宁的粪肠球菌;2株(2/77,2.6%)屎肠球菌对万古霉素和替考拉宁均耐药。大肠埃希菌和克雷伯菌属中产ESBLs株分别占46.6%和27.7%,未发现对亚胺培南和美罗培南耐药的菌株。铜绿假单胞菌对亚胺培南、美罗培南和阿米卡星的耐药率分别为29.5%、36.9%和2.3%。不动杆菌属对米诺环素和头孢哌酮-舒巴坦的耐药率分别为26.4%和12.5%,对其他抗菌药物的耐药率均在60.0%以上。结论除少量屎肠球菌外,革兰阳性菌对糖肽类抗菌药物无耐药。肠杆菌科细菌对亚胺培南、美罗培南、头孢哌酮-舒巴坦、哌拉西林-他唑巴坦和阿米卡星等耐药率低。碳青霉烯类抗生素耐药铜绿假单胞菌和鲍曼不动杆菌检出率显著增高,应加强抗菌药物的合理使用和医院感染监控。Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area during 2011.Methods Antimicrobial susceptibility testing was conducted by Kirby-Bauer method.All the data were analyzed by WHONET 5.5 soft-ware.Results A total of 2 690 clinical isolates were collected during 2011,of which gram negative organisms and gram positive organisms accounted for 74.2% and 25.8%,respectively.MRSA and MRCNS accounted for 45.1% of S.aureus and 71.6%of coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin and erythromycin than the corresponding methicillin-susceptible strains.No vancomycin- or teicoplanin-resistant strain of Staphylococcus spp.was identified.The resistance rate to penicillin,nitrofurantoin and fosfomycin was low in E.faecalis.No ampicillin-,vancomycin-or teicoplanin-resistant strains were found.For E.faecium,some strains were resistant to vancomy-cin and teicoplanin.About 46.6% of E.coli isolates and 27.7% of Klebsiella isolates produced extended-spectrumβ-lactamas-es (ESBLs).No imipenem-or meropenem-resistant isolate was found.The percentage of P .aeruginosa strains resistant to imipenem,meropenem and amikacin were 29.5%,36.9%and 2.3%, respectively. More than 60.0% of the Acinetobacter strains were resistant to all the antibiotics test-ed except minocycline and cefoperazone-sulbactam,to which 26.4% and 12.5% of the strains were resistant.Conclusions No glycopeptides-resistant isolate was found in gram positive organisms except E.faecium.The resistance rate of Enter-obacteriaceae isolates was lower to imipenem,meropenem, cefoperazone-sulbactam,piperacillin-tazobactam and amika-cin.The prevalence of resistant strains is still increasing,es-pecially carbapenem-resistant P .aeruginosa and carbapenem-resistant A.baumannii.It is mandatory to take effective antibiot-ic policy and infection control measures.

关 键 词：细菌 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]