济南军区总医院2006-2007年细菌分离及耐药性分析

Analysis of isolated strains and bacterial resistance to antibiotics in General Hospital of Jinan Military Region of PLA during 2006 to 2007

目的:调查济南军区总医院2006-2007年临床分离细菌的构成及耐药性的动态变化。方法:收集济南军区总医院2006-2007年临床送检标本中分离的菌株,K-B法进行药敏试验,WHONET5.3软件进行耐药性数据分析。结果:铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌、肺炎克雷伯菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌、阴沟肠杆菌和粪肠球菌为最常见菌。各类G+球菌对万古霉素仍保持高度敏感性。G-杆菌中大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌对碳青霉烯类高度敏感,铜绿假单胞菌对碳青霉烯类耐药率>20%,鲍曼不动杆菌对哌拉西林/他唑巴坦的耐药率为49%(2006年)和63.1%(2007年),上升迅速。耐甲氧西林金黄色葡萄球菌的检出率有所下降,产超广谱β-内酰胺酶的菌株检出率有所上升。结论:细菌耐药呈上升趋势,多药耐药日趋严重,掌握细菌耐药谱的变化,对促进抗菌药物的合理应用是非常必要的。

Objective： To investigate the change of clinical isolated strains and bacterial resistance to antibiotics in General Hospital of Jinan Military Region of PLA from 2006 to 2007. Methods： The isolated strains were obtained from all the specimens in the hospital from 2006 to 2007. Drug susceptibility test was carried out by Kirby Bauer method and the data of microbial resistance to antibiotics were analyzed by WHONETS. 3 software. Results： In two years of study, Pseudomonas aeruginosa, Escherichia coli ,Acinetobacter baumanii , Klebsiella pneumoniae, coagulase negative staphylococcus, Staphylococcus aureus, Enterobacter cloacae and Enterococcus faecalis were the most common strains among the isolates. Vancomycin still showed high activity against gram-positive cocci. The susceptibility of Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae to carbopenems was high, but the resistant rate of Acinetobacter baumanii to pipcracillin/tazobactam was increased obviously during the two years（from 49 % in 2006 to 63.1 % in 2007）. The incidence of meticillin resistant Staphylococcus aureus was gradually decreasing. The incidence of E. coli and K. pneumoniae producing extended spectrum β lactamases was raised obviously. Conclusion： Bacterial resistance is rising, andmuti-clrug resistance is getting more serious. It is necessary to monitor the changes of drug resistance of bacteria in order to improve the rational use of antimicrobial agents.