重庆地区儿童2000年至2004年首位革兰阴性细菌和阳性细菌的耐药性监测

Drug resistance surveillance of the first Gram-negative bacteria and Gram-positive bacteria on children in Chongqing region in 2000-2004

目的了解重庆地区儿童感染的分离至临床标本的首位革兰阴性细菌和阳性细菌对常用抗生素的耐药趋势,指导临床合理使用抗生素。方法常规方法分离、培养细菌,应用美国德灵公司W alkAway-40细菌鉴定仪对2000年至2004年我院细菌室分离至临床标本的首位革兰阴性细菌和阳性细菌共2854株进行细菌鉴定及药敏试验。结果2000年至2004年检出的首位革兰阴性细菌和阳性细菌分别为大肠埃希菌和金黄色葡萄球菌。2000年至2004年前5位革兰阴性菌5777株,革兰阳性菌1565株,其中大肠埃希菌2090株,金黄色葡萄球菌764株,分别占36.2%和48.8%;5年间大肠埃希菌对氨苄西林、头孢吡肟、头孢西丁、庆大霉素、亚胺培南、环丙沙星、头孢噻肟、头孢他啶的总耐药率分别为80.9%、37.5%、15.4%、54.0%、0.8%、34.0%、46.6%、46.2%;金黄色葡萄球菌对青霉素、红霉素、复方新诺明、万古霉素、阿莫西林/克拉维酸的总耐药率分别为95.6%、63.4%、5.8%、0%、11.0%。结论通过细菌耐药监测发现:大肠埃希菌对常用抗生素的总耐药率变化不大,金黄色葡萄球菌对常用抗生素的总耐药率有下降趋势,应引起临床医生重视。

Objective To understand the drug resistance tendency of the first Gram-negative bacteria and Gram-positive bacteria separated from clinical samples on children in Chongqing region in 2000- 2004 and instruct clinical rational use antibiotic. Method Dissociating and cultivanting of bacterimn with routine method, a total of 2 854 pieces of clinical dissociating of the first Gram-negative bacteria and Gram-positive bacteria were identified and undertaked susceptibility test were tested by American Microscan WalkAway-40 in 2000-2004. Results Detecting of the first Gram-negative bacteria and Gram-positive bacteria were Escherichia coli and Staphylococcus aureus respectively in 2000-2004. The front fifth Gram-negative bacteria and Gram-positive bacteria were 5777 and 1565 respectively in 2000-2004, among Escherichia coli were 2090, Staphylococcus aureus were 764,which accouted for 36.2% and 48.8% respectively. The rate of drug resistance of Escherichia coli to ampicillin, cefepime, cefoxitin, gentamicin, imipenem, ciprofloxacin, cefotaxim and ceftazidime were 80.9%, 37.5% ,15.4% ,54.0% ,0.8% ,34.0% ,46.6% and 46.2% respectively. The rate of drug resistance of Staphylococcus aureus to penicillin, erythromycin, trimethoprim-sulfamethoxazole, vancomycin and amoxicillin/clavulanic acid were 95.6%, 63.4%, 5.8%, 0% and 11.0%, respectively. Conclusions To surveillance of clinical bacterial resistance discoveried that：the resistance rate of Escherichia coli didn＇t change greatly. The resistance rate of Staphylococcus aureus were descending tendency,the clinical doctors should be noticed.