2008年某院临床分离的常见细菌耐药性监测

Surveillance of antibiotic resistance of the clinical isolates from the patients in our hospital in 2008

目的调查包头医学院第一附属医院2008年临床分离常见细菌对常用抗菌药物的耐药情况。方法收集2008年1～12月临床分离的常见细菌,采用纸片扩散法进行抗菌药物敏感性试验,数据用WHONET5.4进行统计分析。结果 720株临床分离细菌中,其中革兰阳性球菌165株(22.9%),革兰阴性杆菌555株(77.1%)。革兰阳性球菌中前3位分别是肠球菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌。革兰阴性杆菌前3位分别是大肠埃希菌、铜绿假单胞菌、克雷伯菌属。耐甲氧西林金黄色葡萄球菌检出率为45.5%,耐甲氧西林凝固酶阴性葡萄球菌检出率为52.6%。未检出耐糖肽类抗菌药物的革兰阳性球菌。大肠埃希菌和克雷伯菌属中产超广谱β-内酰胺酶(ESBLs)菌株检出率分别为59.1%、53.9%;产ESBLs菌株耐药率均高于非产ESBLs菌株。其他肠杆菌对多数抗菌药物耐药率较高。非发酵糖革兰阴性杆菌的耐药率均较高。结论临床常见病原菌以革兰阴性杆菌为主,革兰阳性球菌对糖肽类抗菌药物耐药率最低;肠杆菌科细菌对亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦的耐药率较低。

Objective To investigate the antibiotic resistance of the clinical isolates to the commonly used antimicrobial agents. Methods Disk diffusion method was used to determine the antimicrobial susceptibility and the data was analyzed by WHONET 5.4. Results 720 strains of clinical isolates were collected,including gram-positive cocci 22.9 % and gram-negative bacilli 77.1%. The top three pathogens of gram positive cocci were Enterococcus SPP, coagulase-negative staphylococcus and S. aureus. The top three pathogens of gram-negative bacilli were E. coli,P, aerug- inosa and klebsiella SPP. The prevalence of MRSA was 45. 5% and MRSCNS was 52. 6%. None of gram-positive cocci was found resistant to glycopeptides. The prevalence of ESBLs producing E. eoli and Klebsiella SPP. was 59. 1% and 53.9% respectively. Conclusion Most of clinical isolates are composed of gram negative bacilli. The resistance rate of gram-positive cocci was the lowest to glycopeptides. The resistance rate of enterobacteriaceae SPP. was lower to the druas such as imipenem,cefoperrazone sulbactam,and piperacillin-tazobacam.