2010-2014年山东省重症医学科非发酵菌耐药率监测  

The surveillance of drug resistance ratio of non-fermentation bacteria in ICU in Shandong province from 2010 to 2014

作　　者：朱熠冰[1] 解建[2] 姜志明[2] 

机构地区：[1]山东中医药大学,山东济南250014 [2]山东大学附属千佛山医院,山东济南250014

出　　处：《医学检验与临床》2015年第6期57-59,共3页Medical Laboratory Science and Clinics

摘　　要：目的：统计2010—2014年山东省34家重症医学科（ICU）临床分离非发酵菌分布及耐药性，分析非发酵菌感染情况及耐药特点，指导临床合理应用抗生素。方法：采用扩散法或稀释法进行药物敏感性试验，结果以CLSI标准判读。结果：2010—2014年共分离病原菌50219株，其中非发酵菌25856株，鲍氏不动杆菌11875株，铜绿假单胞菌11687株，嗜麦芽窄食单胞菌1945株，洋葱伯克霍尔德菌549株。监测结果示鲍氏不动杆菌对所有抗生素耐药率均大于30％，但对米诺环素和头孢哌／酮舒巴坦保持相对较低耐药性。2010年鲍氏不动杆菌对美罗培南和亚胺培南耐药率分别为78．7％和80．0％，2014年上升至90．8％和91．2％。鲍氏不动杆菌整体耐药水平较高且呈升高趋势。铜绿假单胞菌对阿米卡星耐药率小于30％，对其他抗生素耐药率均大于30％，对阿米卡星、头孢哌酮／舒巴坦、左氧氟沙星耐药率相对较低。2010年铜绿假单胞菌对美罗培南和亚胺培南耐药率分别为50．9％和50．8％，2014年下降至36．1％和45．1％。铜绿假单胞菌总体耐药水平明显低于鲍氏不动杆菌。嗜麦芽窄食单胞菌对米诺环素、左氧氟沙星、头孢哌酮／舒巴坦耐药率均小于30％。洋葱伯克霍尔德菌对哌拉西林／他唑巴坦、头孢哌酮／舒巴坦、头孢他啶、美罗培南、左氧氟沙星耐药率均小于30％。结论：山东省重症医学科临床分离病原菌中，非发酵菌检出率高，耐药性强。Objective ： To investigate the bacterial resistance to non-fermentative grams from 34 hospitals in Shandong Province from the Intensive Care Unit during 2010-2014. Methods ： The antimicrobial susceptibility was tested according to an agreed protocol using Kirby-Bauer method. Data were analyzed according to CLSI.Results ： A total of 50219 clinical isolates of pathogens, including 25856 non-fermentative grams：Acinetobacter baumannii （n=11875） ; Pseudomonas aemginosa （n=11687） ; Stenotrophomonas maltophiha （ n=1945 ） ; Brukholderia cepacia （ n=549 ） .Acinetobacter baumannii to Meropenem and Imipenem resistance rates were 78.7% and 80.0% in 2010, raising to 90.8% and 91.2% in 2014.The resistance rate to all antibacterials was more than 30% while to Minocycline and Cefoperazine-sulbactam is relatively acceptable.Pseudomonas aemginosa to Meropenem and Imipenem resistance rates were 50.9% and 50.8% in 2010,down to 90.8% and 91.2% in 2014.The resistance rate to Amikacin was less than 30%,to other antibacterials was more than 30%, and to Amikacin , Cefoperazine-sulbactam and Levofloxacin was relatively acceptable.Stenotrophomonas maltophilia to Minocycline, Levofloxacin and Cefoperazine-sulbactam were less than 30%.Burkholderia cepacia to Piperacillin-tazobactam, Cefoperazine-sulbactam, Ceftazidime, Meropenem and Levofloxacin resistance rates were less than 30%. Conclusions ： The changes of antibiotic resistance differ from the species of bacteria and antibiotics.Therefore this article is aimed at offer some reference.

关 键 词：重症医学科 非发酵菌 耐药率 

分 类 号：R573.1[医药卫生—消化系统]