某院2012年临床常见病原菌耐药性及与Mohnarin报告对比分析  

Antimicrobial resistance of common pathogenic bacteria in a hospital in 2012 and comparison with Mohnarin report

作　　者：施永新[1] 宋卫青[1] 

机构地区：[1]青岛市市立医院,山东青岛266071

出　　处：《中国感染控制杂志》2014年第3期141-147,共7页Chinese Journal of Infection Control

摘　　要：目的了解某院2012年1—12月临床分离的常见病原菌对不同类型抗菌药物的耐药情况,并与2012全国细菌耐药监测网Mohnarin报告作对比,为临床合理使用抗菌药物提供依据。方法对临床送检标本进行培养,检测病原菌的最低抑菌浓度(MIC),并与全国细菌耐药监测结果对比分析耐药率绝对差值,用χ2检验逐个对抗菌药物比较其总体差异性。结果 4种常见革兰阴性菌(鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌)整体耐药率略高于2012年度全国细菌耐药率;金黄色葡萄球菌耐药率低于全国平均水平(P<0.01),其中耐甲氧西林金黄色葡萄球菌(MRSA)检出率为19.25%,低于全国平均水平(46.1%),未检出耐万古霉素菌株。大肠埃希菌、肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)检出率较高,分别为37.54%和21.33%,高于全国平均水平(分别为26.2%和16.2%);多重耐药鲍曼不动杆菌和铜绿假单胞菌检出率分别为9.2%和1.5%,与全国水平相近。结论该院细菌耐药性较稳定。开展细菌耐药性监测,对指导临床合理用药及经验应用抗菌药物具有重要意义。Objective To investigate antimicrobial resistance of commonly isolated pathogenic bacteria in a hospital between January and December 2012, and compared with report of Ministry of Health National Antimicrobial Re- sistance Investigation Net（Mohnarin）, so as to provide reference for the rational use of antimicrobial agents. Methods Clinical specimens were cultured, minimal inhibitory concentration（MIC） of pathogenic bacteria were detected and compared with the absolute difference in drug resistance rate of Mohnarin report, the overall difference in antimicro- bial resistance rates was compared respectively by χ^2 test. Results In 2012, the total resistance of four kinds of gram-negative bacteria （Acinetobacter baumannii ,Escherichia coli ,Klebsiella pneumoniae , Pseudomonas aerugino- sa ） were slightly higher than Mohnarin report; resistance rate of Staphylococcus aureus was lower than average lev- el of Mohnarin report （P〈0. 01）, detection rate of methicillin-resistant Staphylococcus aureus was 19. 25 %, which was lower than 46. 1% of average level of Mohnarin report, vancomycin-resistant bacterial strain was not found. Extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae was higher than average level of Mohnarin report respectively（37. 54% vs 26. 2%; 21.33% vs 16. 2%, respectively）; multidrug-resistant Acine tobacter baumannii and Pseudomonas aeruginosa was 9. 2% and 1.5% respectively, which approximating to the de- tection rate of average level of Mohnarin report. Conclusion Antimicrobial resistance of pathogenic bacteria is stable in this hospital, monitor on bacterial antimicrobial resistance is significant for the rational clinical use of antimicrobial agents.

关 键 词：病原菌 抗菌药物 耐药监测 医院感染 微生物敏感性试验 抗药性 微生物 

分 类 号：R969.3[医药卫生—药理学]