2013年医院病原菌耐药性监测分析  

Surveillance of drug resistance of pathogens in 2013

作　　者：郑春华[1] 李春红[2] 奚伟星[3] 金燕[1] 陈洁[1] 

机构地区：[1]浙江省立同德医院感染科,浙江杭州310012 [2]余杭区五常街道社区卫生服务中心,浙江杭州310000 [3]浙江省立同德医院检验科,浙江杭州310012

出　　处：《中华医院感染学杂志》2015年第5期1042-1044,共3页Chinese Journal of Nosocomiology

基　　金：浙江省自然科学基金资助项目(LQ14C090005)

摘　　要：目的了解2013年浙江省某三甲医院临床分离菌株对常用抗菌药物的耐药性,为临床合理用药提供参考依据。方法共收集2013年1-12月医院临床分离的非重复病原菌2 329株,采用纸片扩散法(K-B)进行药敏试验,结果按照CLSI 2011年标准解释。结果居前6位的病原菌为大肠埃希菌440株、不动杆菌属307株、肺炎克雷伯菌294株、金黄色葡萄球菌224株、铜绿假单胞菌221株及凝固酶阴性葡萄球菌183株,分别占18.89%、13.18%、12.62%、9.62%、9.49%及7.86%;MRSA和MRCNS对临床常用抗菌药物的耐药率分别高于MSSA和MSCNS,未发现耐呋喃妥因和万古霉素葡萄球菌,对青霉素耐药率高达92.31%;大肠埃希菌和肺炎克雷伯菌中产ESBLs菌株对青霉素类、头孢菌素类、喹诺酮类和氨基糖苷类等临床常用抗菌药物的耐药率较高,对阿米卡星、碳青霉烯类抗菌药物的耐药率较低;铜绿假单胞菌对亚胺培南及美罗培南的耐药率分别为31.22%和22.62%。结论定期进行细菌耐药性监测,有助于了解医院细菌耐药性变化,为临床经验用药提供科学依据,并对加强抗菌药物的合理应用的监督和管理起到重要的作用。OBJECTIVE To investigate the drug resistance of clinical isolates to the commonly used antibiotics in a three A hospital of Zhejiang province in 2013 so as to provide guidance for reasonable clinical use of antibiotics . METHODS A total of 2 329 non‐repetitive clinical pathogens were isolated ,then the drug susceptibility testing was performed by using disk diffusion method （K‐B） ,and the results were interpreted on the basis of criteria of CLSI 2011.RESULTSTheEscherichiacoli（440strains）,Acinetobacterspp（307strains）,Klebsiellapneumoniae（294 strains） ,Staphylococcus aureus （224 strains） , Pseudomonas aeruginosa （221 strains） ,and coagulase‐negative Staphylococcus （183 strains ） ranked the top six species of pathogens , accounting for 18 .89% , 13 .18% , 12 .62% ,9 .62% ,9 .49% ,and 7 .86% ,respectively .The drug resistance rate of the MRSA and MRCNS to the commonly used antibiotics were respectively higher than those of the MSSA and MSCNS ;no strain of nitrofuran‐toin‐or vancomycin‐resistant Staphylococcus was found ,and the drug resistance rate to penicillin was as high as 92 .31% ;the ESBLs‐producing E .coli and K .pneumoniae strains were highly resistant to the commonly used anti‐biotics such as penicillins ,cephalosporins ,quinolones ,and aminoglycosides ,while the drug resistance rates to amikacin and carbapenems were low ;the drug resistance rates of the P .aeruginosa to imipenem and meropenem were 31 .22% and 22 .62% ,respectively .CONCLUSION The regular surveillance of bacterial resistance is condu‐cive to the understanding of the change of the drug resistance and can provide scientific basis for clinical empirical medication ,it plays an important role in strengthening the supervision and management of reasonable use of antibiotics .

关 键 词：抗菌药物 病原菌 耐药性 监测 

分 类 号：R378[医药卫生—病原生物学]