2008年河北医科大学第二医院临床分离菌分布及耐药谱型监测

Surveillance report of pathogen distribution and antimicrobial resistance pattern in 2008

目的监测2008年河北医科大学第二医院临床分离病原菌的菌株分布和耐药率。方法药敏试验采用K-B纸片法,数据分析采用WHONET5.4软件。结果该院2008年共分离病原菌3001株,革兰阴性杆菌占67%。大肠埃希菌和铜绿假单胞菌分别占22.7%(683/3001)和17.5%(526/3001),克雷伯菌属和鲍曼不动杆菌分别占15.7%(472/3001)和10.8%(325/3001)。革兰阳性球菌以金葡菌为主,占6.5%(196/3001)。亚胺培南和美罗培南对肠杆菌科细菌保持良好的抗菌活性,但铜绿假单胞菌和鲍曼不动杆菌对其耐药率高于30%;肠杆菌细菌对头孢哌酮-舒巴坦和头孢他啶的耐药率均低于30%;未发现葡萄球菌属对万古霉素和替考拉宁的耐药菌株,但肠球菌属对万古霉素的耐药率达3%～4%;氯霉素和米诺环素对葡萄球菌属和肠球菌属表现了良好的抗菌活性。结论细菌耐药性监测对准确掌握细菌对抗菌药物的耐药模式和耐药性变迁,指导临床合理用药具有重要的意义。

Objective To investigate the pathogen distribution and antimicrobial resistance pattern in 2008. Methods Antimicro bial susceptibility test was conducted by Kirby Bauer method. WHONET 5.4 software was used to analyze the data. Results Of the 3 001 clinical isolates, gram negative Bacilli accounted for 67%. The most common pathogens were E, coli （22.7%, 683/3 001 ） and P. aeruginosa （17.5% , 526/3 001 ）. The proportion of Klehsiella and A. baumanii was 15.7%（472/3 001） and 10. 8% （325/3 001） respectively. S. aureus accounted for 6. 5% of all the gram positive isolates. Enterobacteriaceae strains showed lowest resistance rate to imipenem and meropenem. About 30% of P. aeruginosa and A. baumanii isolates were resistant to imipenem and meropenem, respectively. Not more than 30% of Enterobacteriaceae strains were resistant to cefoperazone sulbactam or ceftazidime. The prevalence of vancomyein-resistant Enterococcus was 3 %-4 %. However, no staphylococcal strain was found resistant to vaneomycin. Staphylococcus and Enterococcus showed lower resistance to chloramphenicol or minocycline. Conclusions Surveillance of antimierobial resistance plays an important role in controlling hospital infections.