2007-2008年重庆儿童医院细菌耐药性监测分析

To analyse of monitoring the antibiotic resistance in the Children’s hospital,university of medical sciences during 2007 to 2008

目的:调查我院住院儿童病原菌及耐药性的流行趋势,为临床合理选用抗菌药物提供参考。方法:回顾性收集2007年1月-2008年12月所有住院患儿病原学及药敏检测资料,病原菌分离、鉴定以微生物自动培养仪(Microscan Walkaway-40)完成,药敏采用Kirby-Bauer琼脂扩散法(K-B)试验并根据NCCLS2000的标准判断,数据用WHONET-5软件进行处理。结果:2年收集到19783份测标本,分离出9种常见病原菌共计9947株,阳性分离率为50.28%,其中革兰阳性菌3626株(分离率36.45%),主要为金黄色葡萄球菌、肺炎链球菌、肠球菌和溶血链球菌,分离出MRSA201株,占金黄色葡萄球菌的13.71%。除溶血链球菌外其余3种革兰阳性菌对普通青霉素类抗生素耐药率较高(59.97%～100.00%),对氧氟沙星较敏感,未发现对万古霉素、替考拉宁耐药株。革兰阴性菌6321株(分离率63.55%),主要为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、流感嗜血杆菌、鲍曼不动杆菌等,分离出产ESBL酶829株(分离率17.68%)。除流感嗜血杆菌、鲍曼不动杆菌外,其余对普通青霉素及其酶复合制剂耐药率均较高(42.11%～100.00%),对亚胺培南等碳青霉希类和氧氟沙星、阿米卡星等较敏感。结论:住院患儿以革兰阴性菌感染为主,细菌的分离率及耐药率保持较高的水平,MRSA和产ESBL的阳性率也较高,病原菌耐药形势严峻。

OBJECTIVE to provide reference for clinical reasonable selection of antimicrobial agents for reference, transit research the epidemiology trends about pathogenic microorganism and antibiotic resistance in Children＇s Hospital. of Chongqing. METHODS Retrospectively collected the microbial laboratory records about hospitalized patients bacteria strains and antibiotic resistance were retrospectively from Jan. 2007 to Dec. 2008. To separate and authenticate bacteria were automatism completed by Microscan Walkaway-40,The test of Antibiotic Resistance were completed by Kirby-Bauer, to estimate result of Antibiotic Resistance by standard of NCCLS 2000,deal with data by software of WHONET-5. RESULTS 2-year measurements were collected samplesl9 783,nine kinds of common pathogenic bacteria isolated from a total of 9947, the positive isolation rate of 50. 28%. Which Gram-positive bacteria 3626 （isolation rate of 36. 45%）, mainly Staphylococcus aureus, Streptococcus pneumoniae, enterococci, and hemolytic streptococcus, isolated MRSA 201 strains of Staphylococcus aureus accounted for 13. 71%., In addition to the other three kinds of things hemolytic streptococcus Gram positive bacteria resistant to ordinary antibiotics, the rate of penicillin was higher （59. 97%- 100. 00%, More sensitive to the ofloxacin, has yet to issue the first to vancomycin, teicoplanin-resistant strains of bacteriao Gram-negative bacteria 632l （isolation rate of 63.55%）, Mainly Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Haemophilus influenzae, Acinetobacter baumannii, etc. ,Separation of produced ESBL enzymes 829 （isolation rate of 17. 68%）. In addition to Haemophilus influenzae, Acinetobacter baumannil, the rest of the general resistance to penicillin and their enzyme preparation rates are relatively high （42. 11 - 100. 00%）, imipenem and other types of carbon and oxygen fluorine Penicillium Greek sand Xing, amikacin and other more sensitive to. CONCLUSION Hospitalized children infected with Gram-negative bacteria mainly bacteria isolation rate and antibiotic resistance rates of the pilot to maintain a high level of multi, MRSA and ESBL producing positive rate is quite high, pathogen resist ance situation is grim.