2009年山东大学附属省立医院细菌耐药性监测及分析

Surveillance and analysis of antibiotic resistance in provincial hospital affiliated to Shandong university during the year 2009

目的了解山东大学附属省立医院2009年临床分离菌株分布及耐药谱。方法收集山东大学附属省立医院2009年首次非重复分离株1 821株,细菌鉴定采用VITEK鉴定系统,药敏试验采用纸片扩散法,数据采用WHONET 5.4软件进行统计分析。结果大肠埃希菌和肺炎克雷伯菌对碳青霉烯类药物最敏感;柠檬酸杆菌属、沙雷菌属对碳青霉烯类药物敏感率较高,肠杆菌属和柠檬酸杆菌属对头孢西丁的耐药率分别为98.6%和85.7%,而沙雷菌属耐药率仅为30%;铜绿假单胞菌对哌拉西林/他唑巴坦、头孢吡肟、哌拉西林、头孢他啶、美罗培南、亚胺培南和头孢哌酮/舒巴坦较敏感,对其他药物敏感率均〈70%;鲍曼不动杆菌对亚胺培南、美罗培南敏感率为82.3%、73.2%,对头孢哌酮/舒巴坦耐药率为11.6%,对其他药物耐药率在15.0%~67.8%;葡萄球菌对万古霉素和利奈唑胺100%敏感,耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌检出率分别为45.0%和86.8%;屎肠球菌和粪肠球菌对万古霉素和利奈唑胺最敏感。结论肠杆菌科细菌对碳青霉烯类药物仍最为敏感,但不发酵糖菌对其耐药率升高;葡萄球菌属中均未发现耐万古霉素菌株。

Objective To investigate the distribution and antimicrobial resistance of clinical isolates from provincial hospital affiliated to Shandong university during the year 2009.Methods A total of 1 821 nonduplicate isolates were collected,then the bacteria were identified with VITEK analysis system and disc diffusion tests were used to study the antimicrobial resistance,all datas were analyed by the software ＂WHONET 5.4＂.Results The E.coli and K.pneumonzae isolates were most susceptible to carbapenems;higher susceptibility were found in the isolates of Enterobacter spp,Citrobacter spp.and Serratia spp.The percentage of isolates resistant to cefoxitin were 98.6% and 85.7% in Enterobaeter spp and Citrobacter spp.,respectively,only 30% of Serratia isolates were resistant;the percentage of P.aeruginosa susceptible to piperacillin-tazobactam,cefepime,piperacillin,ceftazidime,meropenem,imipenem,and cefoperazone-sulbactam were relatively high,but the other antimicrobial agents tested only inhibited less than 70%;the susceptibility of A.baumannii isolates to imipenem and meropenem were 82.3% and 73.2%,and the percentage resistant to cefoperazone-sulbactam was 11.6%,to the other antimicrobial agents tested ranged from 15.0% to 67.8%;Vancomycin and Linezolid inhibited all Staphylococcus isolates,about 45.0% of Staphylococcus aureus,86.8% of coagulase-negative Staphylococcus isolates were methicillin-resistant;Enterococcus faecalis and Enterococcus faecium isolates were most susceptible to vancomycin and linezolid.Conclusions Carbapenems are still the most active agents against Enterobacteriace strains.Nonfermenting bacteria are relatively resistant to carbapenems.None of Staphylococcus isolates is found resistant to vancomycln.