2009年金华市中心医院细菌耐药性监测

Surveillance of drug resistance of bacteria isolated from Jinhua municipal central hospital in 2009

目的了解金华市中心医院2009年临床分离的细菌对各类抗菌药物的耐药性。方法纸片扩散法(K-B法)检测临床分离菌对各类抗菌药物的敏感性,判断标准参照2007年版CLSI文件。结果临床共分离出2224株细菌,其中革兰阴性菌占75.7%,革兰阳性菌占24.3%;耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)分别占51.7%和91.5%,肠球菌属中,屎肠球菌的检出率首次高于粪肠球菌,分别为52.1%、25.5%;屎肠球菌对多数测试药的耐药率高于粪肠球菌,但对氯霉素的耐药率相反;大肠埃希菌和克雷伯菌属中ESBLs检出率分别为53.8%和43.1%;不动杆菌属对头孢哌酮/舒巴坦较敏感,对亚胺培南、美罗培南的耐药率分别为52.2%、60.1%;出现7株泛耐药铜绿单胞菌和5株泛耐药鲍氏不动杆菌。结论医院细菌的耐药现状比较严峻,尤其是泛耐药不发酵糖革兰阴性杆菌的增多,应引起重视,并及早采取预防控制措施。

OBJECTIVE To investigate the resistance of clinical isolates from Jinhua municipal central hospital in 2009.METHODS Antimicrobial susceptibility test was carried out by Kirby-bauer method,the results were analyzed according to CLSI 2007.RESULTS Of 2224 clinical isolates,Gram-negative bacilli and Gram-positive cocci accounted for 75.7% and 24.3% respectively.Methicillin-resistant strains in S.aureus（MRSA） and coagulase-negative Staphylococcus（MRCNS） accounted for 51.7% and 91.5% respectively.In Enterococcus spp,the detection rates of E.faecium strains 52.1% were higher than E.faecalis strains 25.5%（24/94） firstly.The resistant rates of E.faecium strains to most of drugs were higher than those of E.faecalis,however the resistant rates of the later strains to chloramphenicol was higher.ESBLs-producing strains accounted for 53.8% in E.coli and 43.1% in Klebsiella spp.Altough acinetobacter spp were still highly susceptible to cefoperazone/sulbactam,resistance rates to imipinem and meropinem were 52.2% and 60.1%,respectively.7 strains of pan-resistance P.aeruginosa and 5 strains of pan-resistance of A.baunmnnii were found.CONCLUSION The bacteria resistance is fairly severe in our hospital,especially pan-resistant non-fermentative Gram-negative bacilli is increasing.It is urgent for hospitals to take effective control measures.