2009-2010年惠州地区细菌耐药性监测与分析

Surveillance and analysis of bacterial resistance in Huizhou from 2009 to 2010

目的了解惠州地区医院临床分离菌对常用抗菌药物的耐药性。方法惠州地区6所医院临床分离菌采用K-B法按统一方案进行抗菌药物敏感试验,按CLSI 2009年版判断结果,对所得的数据用WHONET 5.4软件进行统计分析。结果 2009年1-12月收集各医院临床分离株共11 105株,其中革兰阳性菌3044株,占27.41%,革兰阴性菌8061株,占72.59%;MRSA、MRCNS的检出率为35.8%和88.1%;未发现耐万古霉素和利奈唑胺革兰阳性球菌;大肠埃希菌、肺炎克雷伯菌产ESBLs的检出率分别为32.6%和30.0%;在非发酵革兰阴性杆菌中,铜绿假单胞菌对头孢哌酮/舒巴坦和哌拉西林/他唑巴坦较敏感,耐药率分别为7.5%和9.2%;鲍氏不动杆菌对头孢哌酮/舒巴坦和亚胺培南较敏感,耐药率分别为5.3%和14.5%;嗜麦芽寡养单胞菌对头孢哌酮/舒巴坦耐药率为6.9%。结论对细菌耐药性进行定期监测有助于了解细菌耐药性的变迁,为临床合理用药提供理论依据。

OBJECTIVE To investigate the resistance of clinical isolates obtained from hospitals in Huizhou to commonly used antimicrobial agents.METHODS A total of 6 hospitals were involved in this program.Bacterial susceptibility testing was performed according to a unified protocol using Kirby-Bauer method.Results were analyzed according to CLSI 2009.The results were statistically analyzed with WHONET 5.4 software.RESULTS A total of 11105 pathogenic strains were clinically isolated in these hospitals from Jan.to Dec.2009.3044（27.41%） and 8061（72.59%） of which were gram-positive cocci and gram-negative bacilli respectively.The constitutional ratios of methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative Staphylococcus were 35.8% and 88.1%,respectively.vancomycin and linezolid resistant gram-positive cocci were not found.The detection rates of extended spectrum beta lactamases in Escherichia coli and Klebsiella pneumonia isolates were 32.6% and 30.0%,respectively.Among non-fermentative gram-negative bacilli,the resistance rates of Pseudomonas aeruginosa to cefoperazone/sulbactam and piperacillin/tazuobatan were 7.5% and 9.2% respectively.Acinetobacter baumannii was susceptible to cefoperazone/sulbactam and Imipenem,with drug-resistance rate of 5.3% and 14.5% respectively.The resistance rate of Stenotrophomonas maltophilia to Cefoperazone/Sulbactam was 6.9%.CONCLUSION Regular surveillance of antimicrobial resistance in clinical isolates is important to understand the trend of antimicrobial resistance and will provide a theoretical basis for rational antimicrobial therapy.