临床分离4 364株细菌的分布特征和耐药性变迁分析

Distribution and Drug Resistance Spectrum of 4 364 Clinical Isolates of Bacteria

目的了解2003-2005年分离的4364株细菌的分布特征及耐药性变迁,为合理使用抗菌药物提供依据。方法大多数分离细菌的鉴定和药敏试验利用BD Phoenix仪,少数利用手工鉴定和K-B法药敏试验。数据分析用WHONET 5.0软件。结果葡萄球菌对万古霉素和替考拉宁的敏感率一直为100%,对其他抗菌药物的耐药率大多逐年上升,甲氧西林耐药率也逐年上升,金黄色葡萄球菌从40.8%上升到61.6%,表皮葡萄球菌从69.7%上升到79.8%。G-杆菌合计,大多数抗菌药物的耐药率逐年升高,耐药率一直低于30%的为美洛培南、亚安培南、头孢哌酮/舒巴坦、哌拉西林-他唑巴坦和头孢他啶。大肠埃希菌和肺炎克雷伯菌体外产ESBLs的检出率一直居高不下,为29.5%～45.5%。结论本院肠杆菌科产ESBLs比例、葡萄球菌甲氧西林耐药率和非发酵菌碳青霉烯类耐药率均较高,应加强抗菌药物的合理使用和采取有效的隔离措施以降低耐药率及多重耐药菌的扩散。

Objective To investigate the distribution and drag resistance spectrum of 4 364 clinical isolates of bacteria in local region from year 2003 to 2005. Methods Most bacteria isolates were identified by BD Phoenix, a few were identified by handy-method and K-B method. WHONET5.0 was applied for analysis. Results In Staphylococci isolates, the susceptibility rates of Vancomycin and Teicoplanin were both 100.0%, while the resistant rates of other antibiotics were increasing year by year. Methicillin resistant rates of S. aureu and S. epidermidis were increased, from 40.8% to 61.6%, and from 69.7% to 79.8%, respectively. In gram negative isolates, resistant rates of Meraopenem, Imipenem, Cefoperazone/Sulbactam, Piperacillin/Tazobactam, and Ceftazidime were below 30%. The incidences of extended spectrum beta-lactamase （ESBLs） producing E.coli and K. pneumoniae isolates were increased from 29.5%- 45.5%. Conclusion The ESBLs producing ferment bacteria, methicillin resistance of Staphylococci, and carbopenems resistance of non-ferment bacteria in local region were abundant, h is important to promote the rational use of antimlcrobial agents and take effective contaminant methods to reduce the antibiotic resistant rates of bacteria and the dissemination of multi-drag resistant bacteria.