1998年上海地区细菌耐药性监测

Surveillance of bacterial resistance in Shanghai in 1998

目的 对上海医院中临床分离菌进行耐药性监测，指导临床合理用药。方法 用ＫｉｒｂｙＢａｕｅｒ 法进行药敏试验，根据１９９７ 年ＮＣＣＬＳ判断结果。结果 临床分离菌中革兰阳性球菌有增多趋势。金黄色葡萄球菌（ＳＡ） 和凝固酶阴性葡萄球菌（ＣＮＳ） 中耐甲氧西林ＳＡ（ＭＲＳＡ） 和耐甲氧西林ＣＮＳ（ＭＲＣＮＳ）分别约占７０－７％ 和５４－９ ％ ，但对万古霉素均敏感。肠球菌属中万古霉素耐药株约５％ ，克雷白菌属、沙雷菌属、肠杆菌属和不动杆菌属对第三代头孢菌素和氟喹诺酮类的耐药率均有显著增高。许多肠杆菌科细菌对亚胺培南的耐药性有缓慢增加趋势。绿脓杆菌对头孢他啶、头孢哌酮和亚胺培南的耐药率比１９９４ 年前有显著增高。结论 合理用药和控制滥用为当务之急。

Objective To investigate the resistance of clinical bacterial isolates as a reference for rational use of antibiotics. Methods Using Kirby Bauer method for bacterial susceptibility testing and NCCLS 1997 as assessment criteria. Results The number of Gram positive organisms was increasing in clinical isolates. Among the Staphalcocci aureus (SA) and coagulase negative Saphylococci (CNS), methicillin resistant SA (MRSA) and methicillin resistant CNS (MRCNS) accounted for 70.7% and 54.9% respectively, but no vancomycin resistant strain was found. Vancomycin resistant Enterococci was about 5%. Resistant rates of Klebsiella spp , Serratia spp , Enterobacter spp and Acinetobacter spp against third generation cephalosporins and fluoroquinolones increased markedly. The resistant rates of most Enterobacteriaceae species against imipenem were increasing gradually, while the resistant rates of Pseadomonas aeruginosa against ceftazidime, cefoperazone and imipenem were significantly higher as compared with the data in 1994. Conclusion The urgent need of restricting the misuse of antibiotics.