2009年大连市中心医院细菌耐药性监测

Surveillance of bacterial resistance from Dalian Centeral Hospital in 2009

目的了解临床常见病原菌的分布及耐药现状,为临床合理使用抗生素提供参考依据。方法采用纸片扩散法进行抗生素敏感性试验。结果共分离病原菌3 202株,其中革兰阴性杆菌占78.8%,革兰阳性球菌占15.7%,真菌占5.5%。大肠埃希菌、肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)检出率分别为68.4%和58.3%,葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为53.6%和61.7%。碳青霉烯类抗生素对大肠埃希菌、肺炎克雷伯菌高度敏感,敏感率为100%,而对铜绿假单胞菌、鲍曼不动杆菌抗菌活性明显降低,敏感率为47.7%～71.6%,革兰阳性球菌对糖肽类和利奈唑胺抗生素高度敏感。结论细菌耐药性不断增强,应及时监测病原菌及耐药性变化趋势,加强抗生素合理使用。

Objective To investigate the pathogenic bacteria distribution and antibiotic resistance of clinical isolates from our hospital in 2009,and povide a basis for clinical treatment.Methods Antibiotic susceptibility tests were performed according tO K-B method.Results were analyzed according to CLSI 2009.and corresponding results were analyzed with WHONET 5.4 software.Resuits A total of 3202 clinical isolates were collected,of which Gram-negative organism,Gram-positive cocci and fungi accounted for 78.8%,15.7%and 5.5%,respectively.The ESBLs producing strains of Escherichia coli and Klebsiella pneumoniae accounted for 68.4%and 58.3%,respectively.Meticillin resistant strains of Staphylococcus aureus and coagulase negative Staphylococcus accounted for 53.6%and 61.7%,respectively.Escherichia coli and Klebsiella pneumoniae showed 100% susceptibility to carbopenems.But the susceptibility of Pseudomonas aeruginosa and Acinetobacter to carbopenems reduced to 47.7%～71.6%.Gram-positive cocci were highly sensitive to glycopeptides and linezolid.Conclusion Bacterial resistance increased,we should monitor pathogens and resistance change timely and strengthen the rational use of antimicrobial agents.