2011-2012年病原菌耐药性变化趋势的研究  

Study on variation trend of drug resistance of pathogens from 2011 to 2012

作　　者：杜龙敏[1] 马涛[1] 侯艺蕾[1] 张芳[1] 

机构地区：[1]银川市第一人民医院感染管理科,宁夏银川750001

出　　处：《中华医院感染学杂志》2014年第12期2885-2887,共3页Chinese Journal of Nosocomiology

基　　金：宁夏回族自治区科技攻关基金资助项目(200858)

摘　　要：目的分析医院临床病原菌的分布特点及耐药性,探讨感染相关因素及病原菌耐药性的变化趋势,指导临床合理使用抗菌药物。方法对2011-2012年医院临床分离菌株进行回顾性分析,使用美国B-D公司生产的Phoenix-100型全自动细菌鉴定仪进行细菌鉴定,药敏试验采用最低抑菌浓度(MIC)法,药敏数据采用WHONET5.4软件进行统计分析。结果 2011-2012年共送检各类标本14 574份,检出病原菌1 742株,检出率为12.0%,其中革兰阳性菌占28.5%,革兰阴性菌占71.5%;2012与2011年比较,金黄色葡萄球菌对庆大霉素、阿米卡星的耐药率呈明显下降趋势;凝固酶阴性葡萄球菌对替考拉宁的耐药率明显升高,对四环素、庆大霉素的耐药率呈明显下降趋势;大肠埃希菌对头孢哌酮/舒巴坦的耐药率呈明显下降趋势,而对环丙沙星、左氧氟沙星、氨苄西林/舒巴坦的耐药率明显升高;克雷伯菌属对头孢哌酮/舒巴坦、头孢他啶、氨曲南的耐药率呈明显下降趋势,而对哌拉西林的耐药率明显升高。结论 2012与2011年相比较,临床病原菌仍呈现出分布广泛、耐药性趋势严重,其中产ESBLs大肠埃希菌和克雷伯菌属检出率较高,发现耐万古霉素革兰阳性球菌、多药耐药鲍氏不动杆菌对亚胺培南高度耐药。OBJECTIVE To analyze the distribution characteristics and drug resistance of clinical pathogens in hospital and to discuss the related risks causing infections and the variation trend of drug resistance of pathogens so as to guide the rational use of antibiotics in clinical practice .METHODS The clinically isolated pathogens in 2011 and 2012 were retrospectively analyzed , the Phoenix-100 full-automatic bacteria identification instrument from Becton-Dickinson company was adopted for bacteria identification ,minimal inhibitory concentration （MIC） method was used for drug sensitivity test ,and WHONET 5 .4 software was adopted for statistically analyzing the drug sensitivity data .Drug sensitive test used the minimum bacteriostatic concentration （M IC ） method .RESULTS A total of 14574 cases of specimens were submitted for inspection in 2011 and 2012;1742 pathogens were detected out ,with the detection rate of 12 .0% ;thereinto ,gram-positive bacteria and gram-negative bacteria accounted for 28 .5% and 71 .5% respectively .Through the comparison between 2012 and 2011 ,it was discovered that the drug resistance rate of Staphylococcus aureus to gentamicin and amikacin presented significant downtrend ,the drug resistance rate of coagulase negative Staphylococcus to teicoplanin presented significant rising trend ,while to tetracycline and gentamicin presented significant downtrend ; the resistance rate of Escherichia coli to cefoperazone/sulbactam presented significant downtrend , while to ciprofloxacin , levofloxacin , ampicillin/sulbactam presented significant rising trend ;the drug resistance rate of K lebsiella to cefoperazone/sulbactam , ceftazidime and aztreonam presented significant downtrend ,while to piperacillin presented significant rising trend . CONCLUSIONS Comparing with that of 2011 , the clinical pathogens are still widely distributed and presented servere trend of drug resistance in 2012 ;the detection rate of ESBLs producing E .coli and K lebsiella is high .It is discovered that vancomycin-resi

关 键 词：病原菌 耐药性 抗菌药物 变化趋势 

分 类 号：R378[医药卫生—病原生物学]