海南省3109株常见致病菌耐药性调查  

Survey of the prevalence of 3109 resistant strains in Hainan province

作　　者：苏林光[1] 贾杰[1] 莫成锦[1] 

机构地区：[1]海南省人民医院,海口570311

出　　处：《中国抗生素杂志》2003年第4期217-220,共4页Chinese Journal of Antibiotics

基　　金：海南省卫生厅重点资助项目 (文号 98 1 0 0 4 )

摘　　要：目的　调查海南省细菌感染的常见致病菌及其对抗菌药物的耐药性 ,为合理应用抗生素提供依据。方法　收集海南省南、中及北区域住院病人标本中分离的 3 10 9株细菌 ,应用API系统对细菌进行鉴定 ,并采用VITEK 3 2系统测定其对临床常用抗菌药物的敏感度。结果　海南省常见的革兰氏阳性菌感染频数依次为葡萄球菌、肠球菌及肺炎链球菌 ;革兰氏阴性菌为铜绿假单胞菌、大肠埃希氏菌、不动杆菌、肺炎克雷伯氏菌及阴沟肠杆菌。药敏结果显示革兰氏阳性菌中葡萄球菌、肺炎链球菌对 β 内酰胺类抗生素明显耐药 ,仅对万古霉素呈现高度敏感 ;肠球菌对 β 内酰胺类抗生素仍呈敏感状态 ;大肠埃希氏菌及肺炎克雷伯氏菌对第三代头孢菌素仍有一定敏感度 ,但产ESBL分别达 3 1%及 2 0 %。铜绿假单胞菌、阴沟肠杆菌及不动杆菌对多种抗生素呈现耐药 ;所有革兰氏阴性菌对亚胺培南均敏感。结论　临床只有重视细菌培养、药敏及 β 内酰胺酶和ESBL检测 ,方可合理使用抗生素。Objective To survey the prevalence of resistant bacteria in Hainan province and the proposed rational use of antibiotics. Methods Three thousand one hundred and nine strains were isolated from the South, Middle and North regional hospitals in the area. The assessment of susceptibility experiments were conducted according to the procedure recommended by NCCLS. Results The sequential prevalence of Gram positive bacteria were Staphylococcus spp. and Streptococcus pneumoniae , and as for Gram negative bacteria were Pseudomonas aeruginosa, E.coli, Acinetobacter spp., Klebsiella pneumoniae and Enterobacter cloacae . The Staphylococcus spp. and Streptococcus pneumoniae were highly resistant to β-lactam antibiotics, but were still extremely susceptible to vancomycin. The Enterococcus spp. were still suseptible to β-lactam antibiotics. E.coli and K.penumoniae were highly susceptible to the third generation cephalosporins, but 31% and 20% of them produced extended spectrum β-lactamases (ESBLs) respectively. P.aeruginosa, E.cloacae and Acinetobacter spp. displayed themselves as multiple resistant strains to many antibiotics. All Gram negative bacilli were susceptible to imipenem. Conclusions The clinical culture susceptibility tests and the ESBL detection test had to be done before the use of antibiotic therapy.

关 键 词：细菌感染 抗菌药物 耐药性 海南 合理用药 

分 类 号：R378[医药卫生—病原生物学] R978.1[医药卫生—基础医学]