安徽省铜陵地区2008年细菌耐药性监测

Surveillance of bacterial resistance in Anhui Tongling area during 2008

目的了解安徽省铜陵地区临床分离菌株耐药状况。方法2008年1—12月铜陵地区临床分离菌株用Kirby-Bauer法进行药敏试验。结果1 476株细菌中革兰阳性菌408株占27.6%;革兰阴性菌1 068株占72.4%;MRSA和MRCNS分别占金葡菌和CNS的24.1%和62.9%;MRSA和MRCNS对庆大霉素、环丙沙星、克林霉素和红霉素等均高度耐药,对利福平和氯霉素的耐药率均较低;未见耐万古霉素葡萄球菌;粪肠球菌对青霉素、氨苄西林、呋喃妥因、磷霉素和氯霉素的耐药率较低,未见耐万古霉素和替考拉宁粪肠球菌;屎肠球菌对磷霉素和氯霉素耐药率较低,发现1株万古霉素耐药屎肠球菌。大肠埃希菌和克雷伯菌属中产ESBLs株分别占49.3%和30.9%,产ESBLs株除对亚胺培南和美罗培南均无耐药外,对其他19种抗菌药物的耐药率均较非产ESBLs株高;不发酵糖菌对亚胺培南、美罗培南和头孢哌酮-舒巴坦等耐药率较低。结论革兰阳性菌对糖肽类抗菌药物耐药率低;肠杆菌科细菌对亚胺培南、美罗培南、头孢哌酮-舒巴坦、哌拉西林-他唑巴坦和阿米卡星等耐药率低。

Objective To investigate the bacterial resistance of clinical isolates collected in Anhui Tongling area.Methods Antimicrobial susceptibility test was conducted by Kirby-Bauer method.Results Of the 1 476 clinical isolates,gram-positive organisms accounted for 27.6%,gram-negative organisms 72.4%.MRSA and MRCNS accounted for 24.1% and 62.9% of S.aureus and coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin,clindamycin and erythromycin;but lower resistance to rifampicin and chloramphenicol.No vancomycin-or teicoplanin-resistant strain of Staphylococcus spp.was identified.The resistance rate to penicillin,ampicillin,nitrofurantion,fosfomycin and chloramphenicol was low in E.faecalis.E.faecium was relatively less resistant to fosfomycin and chloramphenicol.One strain of E.faecium was identified as vancomycin-resistant.About 49.3% of E.coli isolates and 30.9% of Klebsiella isolates produced extended-spectrum β-lactamases（ESBLs）.The resistance rates of ESBLs-producing strains to 19 antimicrobial agents were much higher than those of ESBLs non-producing ones.No imipenem or meropenem-resistant isolate was found.The resistance rate of non-fermenters was lower to imipenem,meropenem and cefoperazone-sulbactam.Conclusions The resistance rate of gram positive isolate is very low to glycopeptides.The resistance rate of Enterobacteriaceae spp.is lower to imipenem,meropenem,cefoperazone-sulbactam,piperacillin-tazobactam and amikacin.