1992年上海地区细菌耐药性监测

BACTERIAL RESISTANCE MONITORING IN SHANGHAI DISTRICT DURING 1992

本文报道１９９２年上海地区１３所医院９７１０株临床分离菌对１９种抗菌药物的耐药性监测结果。其中革兰氏阳性菌２５７２株（２６．５％），革兰氏阴性杆菌７１３８株（７３．５％），以大肠杆菌、绿脓假单胞菌和凝固酶阴性葡萄球菌为多见。甲氧西林耐药葡萄球菌（ＭＲＳＡ和ＭＲＳＥ）约占６０％。万古霉素对革兰氏阳性球菌仍有强大抗菌作用，耐药菌株出现在少数情况。伤寒及其他沙门菌属对氯霉素、氨芋西林和复方新诺明仍显示敏感，对喹诺酮类高度敏感，耐药率＜５％，志贺菌属对多数常用抗生素耐药，但对喹诺酮类显示敬感，尤其对话氟沙星耐药率仅为２％。几年来，多数肠杆菌科细菌和绿脓假单胞菌对哌拉西林、庆大霉素、阿米卡星的耐药率变化不大，对第三代头孢菌素和喹诺酮类耐药率有所增高，约１０～２０％。耐五种以上抗菌药的多重耐药株在某些病房呈相对集中趋势，并具有相同的耐药谱，提示可能有编码相同耐药性质粒的菌株在医院内流行和院内感染的存在。

he results on bacterial resistance monitoring in 13 Sha-nghai hospitals were reported in this paper, Altogether 9710 clinical isol-ates,including 2572 strains(26.5%)of Gram positive cocci and 7138 st-rains(73.5%)of Gram negative bacilli were tested against 19 kinds ofantimicrobial agents.E。coli,Ps。aeruginosa and coagulase negative Stap-hylococci were the main microorganisms.Around 60%of Staphylococci were Methicillin-resistant(MRSA andMRSE).Vancomycin was still the potent drug against Gram positive co-cci and resistant strains were found Only on rare occasions.S. typhi andother Salmonella spp.were still sensitive to Chloramphenicol,Ampicillinand SMZ-Co and highly sensitive to fluoroquinolones,with a resistantrate of less than 5%。Shigella spp.were resistant to most commonly usedantimicrobial agents,but sensitive to fluoroquinolones,resistant rate ofNorfloxacin being 2%only.Resistant rates of most strains of Enteroba-cteriaceae family and Ps.aeruginosa to Piperacillin,Gentamicin,Amika-cin did not change markedly in recent years,but resistant rates to thirdgeneration Cephalosporins and fluoroquinolones were increasin,beingabout 10～20%。Multi-resistant strains(strains resistant to more than 5kinds of antimicrobial agents)showed a tendency to concentrate in somewards and possessed identical reslstant profiles.This suggested that plasmi-ds coding identical resistant profiles spreaded in hospitals and caused noso-comial infections.