江苏大学附属昆山医院2012—2014年细菌耐药性分析  

Surveillance of antibiotic resistance in Kunshan Hospital Affiliated to Jiangsu University from 2012 to 2014

作　　者：顾金花[1] 顾涛[2] 张庆慧[2] 陈玲[2] 徐姿[2] 

机构地区：[1]江苏大学附属昆山医院医院感染管理科,江苏昆山215300 [2]江苏大学附属昆山医院医院检验科,江苏昆山215300

出　　处：《中国感染与化疗杂志》2016年第5期637-643,共7页Chinese Journal of Infection and Chemotherapy

摘　　要：目的了解江苏大学附属昆山医院2012—2014年临床常见分离菌的分布及其对抗菌药物的耐药情况,为临床用药提供依据。方法采用自动化仪器和纸片扩散法(K-B法)对3年中临床分离的5 471株细菌进行药敏试验并按CLSI 2015年标准判断结果。结果 5 471株临床分离株中革兰阳性菌936株(17.1%),革兰阴性菌4 535株(82.9%)。甲氧西林耐药金黄色葡萄球菌(金葡菌,MRSA)和凝固酶阴性葡萄球菌(MRCNS)在各自菌种中的检出率为39.0%和75.6%,未发现耐万古霉素和利奈唑胺的金葡菌。MRSA对抗菌药物的耐药率均高于甲氧西林敏感金葡菌(MSSA)。肠球菌中屎肠球菌对大多数抗菌药物的耐药率高于粪肠球菌,屎肠球菌和粪肠球菌对万古霉素的耐药率分别为5.3%和0.4%。革兰阴性菌中肠杆菌科细菌产ESBL株对抗菌药物的耐药率均显著高于非产ESBL株。鲍曼不动杆菌对抗菌药物有较高的耐药率。结论细菌耐药情况严重,临床应重视细菌耐药性监测并根据结果合理使用抗菌药物。Objective To examine the distribution and antibiotic resistance of common clinical isolates in Kunshan Hospital Affiliated to Jiangsu University from 2012 to 2014. Methods A total of 5 471 clinical isolates were isolated from clinical specimens. Automated systems and disk diffusion method were used to determine the susceptibility of these bacterial isolates according to American Society of Clinical and Laboratory Standards Institute （CLSI） 2015 guidelines, Results Of the 5 471 strains, 936 （17.1%） were gram-positive bacteria, and 4 535 （82.9 %） were gram-negative bacteria. The prevalence of methicillin-resistant S. aureus （MRSA） and coagulase-negative Staphylococcus （MRCNS） was 39.0 % and 75.6 %, respectively. No S. aureus strain was found resistant to vancomycin or linezolid. MRSA strains showed higher resistance rate to most antimicrobial agents than methicillinsensitive strains （MSSA）. Overall, 5.3 % of the E. faecalis and 0.4% of the E. faecium strains were resistant to vancomycin. As for the gram-negative bacteria, ESBLs-producing Enterobacteriaceae strains were generally more resistant than non-ESBLs- producing strains. A. baumannii isolates were highly resistant to most antimicrobial agents. Conclusions As antibiotic resistance is getting worse, we should pay more attention to the monitoring of antimicrobial resistance and rational use of antibiotics based on susceptibility testing.

关 键 词：细菌耐药性监测 药物敏感性试验 抗菌药物 

分 类 号：R446.5[医药卫生—诊断学]