安徽省铜陵地区2012年细菌耐药性监测  

Surveillance of bacterial resistance in Anhui Tongling area during 2012

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 陈自武 朱向阳 

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]铜陵市立医院 [4]铜陵市第四人民医院 [5]铜陵市第二人民医院 [6]铜陵市中医院 [7]铜陵县人民医院

出　　处：《中国感染与化疗杂志》2014年第4期310-315,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WHONET5.6软件进行耐药性分析。结果 2012年共收集非重复临床分离株3 092株,其中革兰阴性菌2 359株,占76.3%,革兰阳性菌773株,占23.7%。甲氧西林耐药金葡菌(MRSA)和甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)分别占金葡菌和凝固酶阴性葡萄球菌的50.9%和73.0%;MRSA和MRCNS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。未见耐万古霉素和替考拉宁的粪肠球菌;屎肠球菌出现个别菌株对万古霉素和替考拉宁耐药。大肠埃希菌和克雷伯菌属中产ESBLs株分别占52.1%和42.1%,发现对碳青霉烯类耐药的肺炎克雷伯菌。铜绿假单胞菌对阿米卡星、头孢哌酮-舒巴坦、头孢吡肟的耐药率分别为3.4%、14.0%和17.7%。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42.1和4.4%,对其他抗菌药物耐药率均在70%以上。结论细菌耐药性仍呈增长趋势,多重耐药和泛耐药菌株在某些科室内的流行播散对临床构成严重威胁,应重视细菌耐药性监测并加强抗菌药物的合理使用和控制医院感染。Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area. Methods Antimicrohial susceptibility test was conducted by Kirby Bauer method. All the data were analyzed with WHONET 5. 5 software. Results A total of 3 092 clinical isolates were collected during 2012, of which gram negative organisms and gram positive organisms accounted for 76.3% （2 359/3 092） and 23.7% （773/3 092）, respectively. MRSA and MRCNS accounted for 50.9% of S. aureus and 73.0 % of coagulase negative Staphylococcus, respectively. MRSA and MRCNS showed higher resistance to gentamicin, ciprofloxacin and erythromycin. No vancomycin- or teicoplanin-resistant strains of Staphylococcus spp. were found. No vancomycinor teicoplanin-resistant strains of E. faecalis were found. Some E. faecium strains were resistant to vancomycin and teicoplanin. About 52.1% of E. coli isolates and 42.1% of Klebsiella isolates produced extendedspectrum β-lactamases （ESBLs）. Imipenem- or meropenemresistant strains of K. pneumoniae were found. The percentage of P. aeruginosa strains resistant to amikacin, cefoperazone-sulbactam and cefcpime was 3.4%, 14.0% and 17.7%, respectively. More than 70% of Acinetobacter spp. strains were resistant to all the antibiotics tested except minocycline and cefoperazon sulbactam, to which 42. 1 and 4. 4% of the strains were resistant. Conclusions The antibiotic resistance of clinical bacterial isolates is growing. The spread of multi-drug or pan-drug resistant strains in a specific region poses a serious threat to clinical practice. We should pay more attention to resistance surveillance and the rational use of antibiotics.

关 键 词：细菌 耐药性 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]