2010年临床分离常见革兰阴性杆菌耐药监测结果分析

Analysis of the Surveillance to Antimicrobial Resistance in Clinical Gram-negative Bacillus in 2010

目的:分析2010年临床分离分离革兰阴性杆菌的耐药情况,了解本地的常见革兰阴性杆菌的分离及耐药流行情况。方法:运用WHONET5.4软件对2010年分离的常见临床革兰阴性杆菌进行统计分析。结果:在2010年分离的常见革兰阴性杆菌中,大肠埃希菌、肺炎克雷伯菌及铜绿假单胞菌分别占前三位。大肠埃希菌、肺炎克雷伯菌产ESBLs的检出率分别为72.22%、43.75%,产ESBLs株的耐药率明显高于非产ESBLs株,大肠埃希菌产ESBLs株对头孢他啶、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南的耐药率分别为32.1%、3.6%、25%0、%;肺炎克雷伯菌产ESBLs株对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南的耐药率分别为35.3%、38.9%、0%。除大肠埃希菌和肺炎克雷伯菌以外的其他肠杆菌科细菌对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、亚胺培南的耐药率为17.9%、14.3%0、%。铜绿假单胞菌对哌拉西林/他唑巴坦、亚胺培南、头孢他啶、孢哌酮/舒巴坦的耐药率分别为4.8%、5%、0%、4.8%。结论:本地的耐药情况与全国其他地方有相似的,但也有不同之处,所以我们应该加强本地耐药监测,特别是对ESBLs的监测更为重要,以便为临床合理用药提供依据,从而帮助控制耐药株的不断出现。

To analyze the antimicrobial resistance among clinical gram-negative bacillus from our hospital in 2010. Methods：antibacterial agents were determined by K-B method. Results：The prevalence of extended-spectrum β-lactamases（ESBL） was 72.22% in Escherichia coli,43.75% in Klebsiella pneumoniae,the resistance rates of ESBLs producing in Escherichia coli for ceftazidime,piperacillin/tazobactam,cefoperazone/sulbactam,imipenem was 32.1%,3.6%,25%,0%,the resistance rates of ESBLs producing in Klebsiella pneumoniae for piperacillin/tazobactam,cefoperazone/sulbactam,imipenem was 35.3%、38.9%、0%.Other Enterobacterium＇s resistance rates to piperacillin/tazobactam,cefoperazone/sulbactam,imipenem was 17.9%、14.3%、0%.The resistance rates of Pseudomonas aeruginosa to piperacillin/tazobactam,imipenem,ceftazidime,cefoperazone/sulbactam was 4.8%、5%、0%、4.8%. Conclusions：The local resistance and the rest area of the country have similar,but there are also differences,we should strengthen its monitoring of local resistance,particularly on ESBLs so that we can provide the basis of rational antibiotica use and help to control the antibiotics-resistant strains continue to emerge.