2005年北京医院细菌耐药性监测

Surveillance of bacterial resistance in Beijing Hospital during 2005

目的了解2005年北京医院临床分离菌对常用抗菌药物的耐药性。方法采用纸片Kirby-Bauer法,对我院2005年全年分离的1225株临床分离株进行药物敏感性试验,WHONET统计软件对数据进行分析。结果2005年临床分离出的革兰阴性杆菌数量多于革兰阳性球菌。细菌构成比中,前3位革兰阴性杆菌分别为铜绿假单胞菌(16.3%)、大肠埃希菌(14.6%)和嗜麦芽窄食单胞菌(11.3%);在革兰阳性球菌中,前3位分别为凝固酶阴性葡萄球菌(7.7%)、金葡菌(6.9%)和粪肠球菌(2.7%)。体外药敏试验结果显示β-溶血链球菌未见青霉素耐药菌株。流感嗜血杆菌β内酰胺酶产酶率为13%。对甲氧西林耐药的金葡菌和凝固酶阴性葡萄球菌分别为78.6%和33.0%。发现1株耐万古霉素的屎肠球菌,为VanB型。大肠埃希菌ESBLs产酶率为30.2%,肺炎克雷伯菌为12.3%,发现1株对碳青霉烯类抗菌药物中介的肺炎克雷伯菌。铜绿假单胞菌和不动杆菌属已出现多重耐药株。结论定期进行耐药性监测有助于了解我院细菌耐药性变迁,为临床经验用药提供理论依据。

Objective To investigate the resistance of clinical isolates from Beijing Hospital in 2005. Methods Using Kirby-Bauer method to test the susceptibility of 1 225 clinical isolates to antimicrobial agents. The data were analyzed by WHONET software. Results The top 3 gram negative species were Pseudomonas aeruginosa （16. 3%）, Escherichia coli （14. 6%） and Stenotrophomonas maltophilia （1 1.3% ）. The top 3 gram positive species were coagulase-negative Staphylococcus （7.7%）, Staphylococcus aureus （6. 9%） and Enterococcus faecalits （2. 7%）. In 2005, the total number of gram negative bacilli was more than gram positive cocci. Susceptibility testing showed that no penicillin-resistant β-hemolytic Streptococcus was identified. Thirteen percent of H. in fluenzae isolates produced β-lactamase. About 78.6% of S. aureus and 33.0% of coagulasenegative Staphylococcuas isolates were methicillin-resistant. One strain of E. faecium was resistant to vancomycin （Vane type）. ESBLs were produced by 30.20% of E. coli isolates and 12.30/00 of Klebsiella isolates. One strain of K. pneumoniar was intermediate to carbapenems. Multi-drug resistant strains were identified in P. aeruginosa and Acinetobacter spp. Conclusions Regular surveillance of antibiotic resistance in clinical isolates is most important and valuable for understanding the trend of antimicrobial resistance and rational antimicrobial therapy.