2004-2008年细菌耐药监测结果分析

Surveillance and analysis of bacterial resistance between 2004 and 2008

目的了解河南地区细菌的耐药状况,监测2004-2008年革兰阴性杆菌和革兰阳性球菌的耐药性。方法药敏试验采用K-B纸片扩散法,采用WHONET5.3软件对患者首次分离菌株进行耐药数据分析。结果 2004至2008年共分离病原菌10 559株,其中革兰阴性杆菌7355株,占69.7%,革兰阳性菌3204株,占30.3%,革兰阴性杆菌中大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌居前3位;大肠埃希菌对氨苄西林、磺胺甲噁唑/甲氧苄啶、哌拉西林等耐药率较高,对亚胺培南、头孢他啶、头孢吡肟等耐药率较低,铜绿假单胞菌对磺胺甲噁唑/甲氧苄啶、阿莫西林/克拉维酸、氨苄西林等耐药率较高,对亚胺培南、头孢哌酮/舒巴坦、头孢吡肟等耐药率较低;革兰阳性球菌耐药率从2004年以后呈逐年上升趋势,耐药率相对较低的有亚胺培南、头孢唑林、头孢吡肟,尚未有万古霉素耐药株的出现。结论河南地区耐药检测对于了解耐药状况和指导临床用药有一定的价值。

OBJECTIVE To learn about the bacterial resistance in Henan province between 2004 and 2008 by identifying the drug resistance of Gram-negative bacilli and Gram-positive cocci. METHODS The Kirby-Bauer method was adopted in the drug sensitive test. The software WHONET5.3 was applied in analyzing the drug- resistance data of the first isolated strains from patients. RESULTS A total of 10559 strains of pathogens were found during the period of 2004--2008, among which 7355 strains were Gram-negative bacilli （69.7%）, and 3204 strains were Gram-positive cocci （30.3 %）, respectively. Of the Gram-negative bacilli, Escherichia coli, Pseudo- monas aeruginosa, and Klebsiella pneumonia were listed on the top three. The drug resistance rates of E. coli to AMP, SXT, PIP were high, but low to IPM, CAZ, FEP. Pseudomonas aeruginosa was with high resistance rate to SXT, AMC and AMP, but low resistance rate to IPM, CSL and FEP. The resistance rate of Gram-positive cocci has been increasing since 2004, with the relative low resistance rate of IPM, CZO and FEP. No strains resistant to vancomycin have been found in this area. CONCLUSION The resistance testing can provide reference for the clinical medication in this area and for the exploration of the drug resistance as well.