我院2008-2012年临床分离细菌分布和耐药性监测  

Distribution of Clinical Isolated Strain and Resistance Monitoring in Our Hospital during 2008-2012

作　　者：何卡乐[1] 黄月莹[1] 张涛[2] 刘弘[1] 

机构地区：[1]解放军第152中心医院药学部,河南平顶山467000 [2]解放军第152中心医院检验科,河南平顶山467000

出　　处：《中国药房》2014年第26期2429-2431,共3页China Pharmacy

摘　　要：目的：了解医院细菌耐药趋势,指导临床合理使用抗菌药物。方法：监测我院2008-2012年临床分离细菌的耐药状况,用Kirby-Bauer纸片扩散法检测细菌耐药性,参照2008-2012版美国临床实验室标准化协会（CLSI）标准判定药敏结果,并用WHONET5.4软件统计分析。结果：5年收集该院临床分离菌共10 653株,革兰阳性菌感染呈上升趋势,耐甲氧西林金黄色葡萄球菌（MRSA）的检出率在30.8%~74.1%之间,耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）的检出率在60.7%~74.0%之间。未发现对万古霉素、替考拉宁、利奈唑胺耐药的葡萄球菌属。革兰阴性菌对青霉素类、头孢菌素类耐药率高;在革兰阴性杆菌中肠杆菌科以大肠埃希菌最多见,非发酵菌科以铜绿假单胞菌多见。肠杆菌科细菌中产超广谱β-内酰胺酶（ESBLs）的大肠埃希菌占42.3%~65.2%;肺炎克雷伯菌占40.9%~70.1%。结论：细菌耐药性仍呈增长趋势,定期对医院细菌耐药性进行监测有助于了解细菌耐药性变迁,为临床经验应用抗菌药提供依据。OBJECTIVE： To investigate the resistance tendency of clinical isolates, and to guide rational use of antibacterial in the clinic. METHODS： Drug resistance of clinical isolates in our hospital during 2008--2012 was monitored, and Kirby-Bauer disk diffusion method was used to detect bacterial resistance. The data were analyzed by using WHONE5.4 statistic software in accordance with 2008- 2012 version of CLSI standard. RESULTS： A total of 10 653 clinical isolates were collected within 5 years; Gram-positive bacterial infections was increasing; the detection rates of methicillin-resistant Staphylococcus aureus （MRSA） were 30.8%-74.1%, and those of methicillin resistant coagulase negative Staphylococcus （MRCNS） were 60.7%-74.0%. No vancomycin, teicoplanin and linezolid resistant strains were found. Gram-negative bacteria showed high drug resistance to penicillin and cephalosporins; Escherichia coli was the most common in Enterobacteriaceae of Gram-negative bacteria; Pseudomonas aerugino＇sa was more common in non-fermenting of Gram-negative bacteria. E. coli of Enterobacteriaceae producing extended-spectrum β-lactamases （ESBLs） accounted for 42.3 %-65.2 %; Klebsiella pneumonia accounted for 40.9%-70.1%. CONCLUSIONS： Bacterial resistance is still increasing; regular monitoring of hospital bacterial resistance helps to understand the changes of bacterial resistance, and provide the basis for the clinical experience of the application of antibacterial.

关 键 词：细菌 耐药性监测 抗菌药物 

分 类 号：R378.2[医药卫生—病原生物学] R446.5[医药卫生—基础医学]