医院临床常见细菌耐药性监测  

Monitoring of drug resistance of common bacteria in hospital

作　　者：尧荣凤[1] 许国祥[2] 陶振东 薛龙[1] 李智[1] 徐龙[1] 

机构地区：[1]上海市杨浦区中心医院检验科,上海200090 [2]上海市第七人民医院康复科,上海200137 [3]南昌市中西医结合医院检验科,江西南昌330003

出　　处：《国际检验医学杂志》2015年第5期638-640,共3页International Journal of Laboratory Medicine

摘　　要：目的了解医院临床常见细菌的耐药情况。方法采用VITEK-2对临床分离株进行鉴定和药敏试验,耐药性数据分析采用WHONET 5.5软件。结果 2009年1月至2012年12月共收集医院患者首次分离的13 841株细菌,其中革兰阳性菌29.3%,革兰阴性菌70.7%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)分别占各自菌种的78.3%和88.4%,未发现耐万古霉素和替加环素的葡萄球菌。有4.3%粪肠球菌和7.5%屎肠球菌对万古霉素耐药。肠杆菌科细菌对碳青霉烯类抗菌药物仍比较敏感,产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和克雷伯菌属(肺炎克雷伯菌+产酸克雷伯菌)的检出率分别为58.5%和24.4%。铜绿假单胞菌和不动杆菌属(含82.8%鲍曼不动杆菌)对亚胺培南耐药率分别为24.9%和42.6%。结论细菌耐药性仍对临床抗感染治疗构成严重威胁,应合理使用抗菌药物以降低耐药性。Objective To understand the drug resistance situation of clinical common bacteria in hospital.Methods VITEK-2was adopted to perform the identification and antimicrobial susceptibility test.The drug resistance data were analyzed by adopting the WHONET 5.5software.Results 13 841 strains of bacteria isolated for the first time from the patient were collected from January 2009 to December 2012,in which Gram positive bacteria accounted for 29.3% and Gram negative bacteria accounted for70.7%.Meticillin-resistant Staphylococcus aureus（MRSA）and meticillin-resistant coagulase-negative staphylococci（MRCNS）accounted for 78.3% and 88.4% of staphylococci aureus and coagulase-negative staphylococci,respectively.No vancomycin and tigecycline resistant strains of staphylococci were found.4.3% of enterococcus faecalis and 7.5% of enterococcus faecium were resistant to vancomycin.The detection rates of E.coli and Klebsiella spp（Klebsiella pneumoniae＋Klebsiella bacteria producing acid）producing extended spectrum beta-lactamases（ESBLs）were 58.5% and 24.4%,respectively.Enterobacteriaceae strains were still more sensitive to carbapenem antibiotics.The resistance rates of pseudomonas aeruginosa and Acinetobacter spp strains to imipenem were 24.9 % and 42.6%,respectively.Conclusion Bacterial drug resistance still constitutes a serious threat to the clinical anti-infection therapy.So the antibacterial agents should be rationally used for reducing the bacterial drug resistance.

关 键 词：细菌耐药性 抗菌药 药敏试验 

分 类 号：R446.5[医药卫生—诊断学]