多药耐药菌感染的耐药性分析

Multi-drug Resistant Organism Infection:Analysis of Drug Resistance

目的分析医院多药耐药（MDR）菌的检测及耐药性,指导临床合理应用抗菌药物。方法自2008年1-12月分离得到的菌株用ATB Expression自动细菌鉴定仪进行菌株鉴定和药敏试验。结果 66株金黄色葡萄球菌（SAU）中,共检出耐甲氧西林金黄色葡萄球菌（MRSA）43株,检出率65.2%;62株肠球菌属中,共检出耐万古霉素肠球菌（VRE）7株,万古霉素中介肠球菌2株,检出率14.5%;112株大肠埃希菌（ECO）中,共检测出产超广谱β-内酰胺酶（ESBLs）52株,检出率46.4%;52株肺炎克雷伯菌中共检出产ESBLs22株,检出率42.3%;16株阴沟肠杆菌中,检出产ESBLs9株,检出率56.3%;12株鲍氏不动杆菌中,产ESBLs8株,检出率66.7%;44株铜绿假单胞菌中,检出产ESBLs11株,检出率25.0%;其他5株细菌中检出产ESBLs3株。结论调查结果表明,MRSA、VRE、产ESBLs细菌对各类抗菌药物的耐药严重,因此,加强对多药耐药菌的检测及耐药性监测,对使用抗菌药物具有重要意义。

OBJECTIVE To detect and analyze the multi-drug resistant（MDR）organisms in order to rationally use the antimicrobial agents.METHODS The strains isolated from Jan to Dec 2008 were tested by ATB Expression on identification of multiple drug-resistantce and drug sensitivity test.RESULTS Among 66 Staphylococcus aureus strains,43 were Meticillin-resistant S.aureus（MRSA）with the detection rate of 65.2%.From 62 Enterococcus strains 7 Vancomycin-resistant enterococcus（VRE）and 2 were Vancomycin-intermediate ones with rate of 14.5%.From 112 Escherichia coli（ECO）strains 52 were extended-spectrum β-lactamases（ESBLs）ones.with rate of 46.4%.of 52 Klebsiella pneumoniae（KPN）strains produced ESBLs with rate of 42.3%.Among 16 Enterobacter cloacae（ECL）,strains 9 had ESBLs with detection rate of 56.3%.Eight of 12 Acinetobacter baumannii（ABA）strains produced ESBLs with Rate of 66.7%.One-fourth of 44 Pseudomonas aeruginosa（PAE）produced ESBLs and in the five strains of other bacteria,3 were ESBLs positive.CONCLUSIONS The MRSA and VRE strains which produce ESBLs have strong resistance against various kinds of antimicrobial agents.It is very meaningful to strengthen detection of multiple drugresistantce for rational use of antimicrobial agents.