云南省楚雄州中医院2009年细菌耐药性监测结果

Surveillance of bacterial resistance in the Hospital of Traditional Chinese Medicine of Chuxiong Prefecture during year 2009

目的了解2009年云南省楚雄州中医院临床分离菌株对常用抗菌药物的耐药性。方法采用ATB药敏试验板条及纸片扩散法对该院2009年临床分离菌906株进行药敏试验。结果 906株细菌中革兰阴性菌633株,占69.9%,革兰阳性菌273株,占30.1%。革兰阴性菌中大肠埃希菌占49.1%(313/633),克雷伯菌属占10.7%(68/633),肠杆菌属占10.0%(63/633);革兰阳性菌中,金葡菌16.1%(44/273),凝固酶阴性葡萄球菌(CNS)27.1%(74/273),肠球菌属39.6%(108/273)。药敏试验结果显示大肠埃希菌和肺炎克雷伯菌ESBLs检出率分别为52.4%和55.0%;1株肺炎克雷伯菌对亚胺培南和美罗培南表现为耐药。铜绿假单胞菌和不动杆菌属分别检出10.7%(3/28)和6.8%(3/44)泛耐药菌株;MRSA和MRCNS分别占金葡菌和CNS的27.3%(12/44)和90.5%(67/74)。结论定期进行细菌耐药性监测有助于了解细菌耐药性的变迁,为临床经验用药提供依据。

Objective To investigate the resistance of clinical isolates in Hospital of Traditional Chinese Medicine of Chuxiong Prefecture from January through December in 2009. Methods Anlimicrobial susceptibility testing of 906 clinical isolates were carried out by Kirby Bauer （K-B） method and microdilution method. Results Of the 906 clinical isolates, gram negative and gram positive bacteria accounted for 69.9% and 30. 1% , respectively. Of the 633 gram negative bacilli, E. toll, Klebsiella spp. and Enterobaeter spp. accounted for 49.1% （313/633）, 10.7% （68/633） and 10.0%（63/633）, respectively. Among the 273 gram positive cocci, S. aureus, coagulase negative Slaphylococcus and Enterococcus spp. accounted for 16. 1% （44/ 273）, 27. 1%（74/273） and 39.6% （108/273）. About 52.4% of E. coli and 55.0% of K. pneumoniaeisolates were ESBLs producing strains. One K. pzzeumoniae isolate was resistant to both imipenem and meropenem. About 10. 7% （3/28） of P. aerugitlosa, 6.8% （3/44） of Acinetobacler spp. were pan-drug resistant. The prevalence of methicillin resistant Staphylococ cus was 90.5%（67/74） in S. aureus and 27. 3% （12/44） in coagulase-negative Staphylococcus. Conclusions Surveillance of bacterial resistance is most important and valuable for guidance of rational selection of antimicrobial agents.