安徽省铜陵地区2009年细菌耐药性监测

Surveillance of bacterial resistance in Anhui Tongling area during 2009

目的了解安徽省铜陵地区临床分离菌株耐药状况。方法 2009年1—12月铜陵地区临床分离菌1 977株用Kirby-Bauer法进行药敏试验。结果 1 977株细菌中革兰阳性菌430株,占21.8%;革兰阴性菌1 547株,占78.2%;MRSA和MRC-NS分别占金葡菌和CNS的21.5%和61.6%;MRSA和MRCNS对庆大霉素、环丙沙星、克林霉素和红霉素等均高度耐药,对利福平和氯霉素的耐药率均较低;未见耐万古霉素和替考拉宁葡萄球菌;粪肠球菌对青霉素、氨苄西林、呋喃妥因、磷霉素和氯霉素的耐药率较低;屎肠球菌对磷霉素和氯霉素耐药率较低,未见耐万古霉素和替考拉宁肠球菌。大肠埃希菌和克雷伯菌属中产ESBLs株分别占53.4%和44.4%,产ESBLs株除对亚胺培南和美罗培南均无耐药外,对其他19种抗菌药物的耐药率均较非产ESBLs株高;不发酵糖菌对常用抗菌药物的耐药率较往年上升。结论革兰阳性菌对糖肽类抗生素无耐药;肠杆菌科细菌对亚胺培南、美罗培南、头孢哌酮-舒巴坦、哌拉西林-他唑巴坦和阿米卡星等耐药率低;不发酵糖菌对常用抗菌药物的耐药率较往年上升。

Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area.MethodsAntimicrobial susceptibility test was conducted by Kirby-Bauer method.ResultsOf the 1 977 clinical isolates,gram positive organisms accounted for 21.8%,gram negative organisms 78.2%.MRSA and MRCNS accounted for 21.5% and 61.6% of S.aureus and coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin,clindamycin and erythromycin,but lower resistance to rifampicin and chloramphenicol.No vancomycin-or teicoplanin-resistant strain of Staphylococcus spp.was identified.The resistance rate to penicillin,ampicillin,nitrofurantion,fosfomycin and chloramphenicol was low in E.faecalis.E.faecium was relatively less resistant to fosfomycin and chloramphenicol.No strain of Enterococcus spp.was identified as vancomycin-or teicoplanin-resistant.About 53.4% of E.coli isolates and 44.4% of Klebsiella isolates produced extended-spectrum β-lactamases（ESBLs）.The resistance rates of ESBLs-producing strains to 19 antimicrobial agents were much higher than those of ESBLs non-producing ones.No imipenem or meropenem-resistant isolate was found.The resistance rate of non-fermenters was higher than that in previous years.ConclusionsNo gram positive isolate was found resistant to glycopeptides.The resistance of Enterobacteriaceae was lower to imipenem,meropenem,cefoperazone-sulbactam,piperacillin-tazobactam and amikacin.The resistance rate of non-fermenters is increasing.