2009年中山大学附属东华医院细菌耐药性监测

Surveillance of bacterial resistance in Donghua Hospital of Zhongshan University in 2009

目的了解2009年中山大学附属东华医院临床分离菌对常用抗菌药物的耐药性。方法采用纸片扩散法(Kirby-Bauer)检测临床分离菌对各种常用抗菌药物的耐药性,参照CLSI 2009年版标准判定药敏试验结果,并用WHONET 5.4软件统计分析。结果全年共检出细菌2 456株,其中革兰阳性菌1113株,占45.3%,革兰阴性菌1 343株,占54.7%。MRSA和MRCNS分别占金葡菌和凝固酶阴性葡萄球菌(CNS)的33.0%(66/200)和64.6%(286/396),未发现耐万古霉素葡萄球菌;大肠埃希菌和肺炎克雷伯菌产ESBI菌株的检出率分别为57.1%和35.7%,各种肠杆菌科细菌均对亚胺培南敏感;铜绿假单胞菌和鲍曼不动杆菌对亚胺培南的的耐药率分别为9.6%和3.0%;未发现泛耐药菌株。结论定期进行细菌耐药性监测有助于了解该院细菌耐药性变迁,为临床经验用药提供依据。

Objective To investigate the antibiotic resistance of clinical isolates collected from Donghua Hospital in 2009.Methods Kirby-Bauer method was used to test the susceptibility of clinical isolates to selected antimicrobial agents.Results were analyzed according to 2009 CLSI standards.The susceptibility data were analyzed using WHONET 5.4 software.Results A total of 2 456 strains were isolated from various clinical specimens.Gram positive cocci and gram negative bacilli accounted for 45.3%and 54.7%,respectively.The prevalence of methicillin-resistant Staphylococcus was 33.0%（66/200） in S.aureus and 64.6%（286/396） in coagulase-negative Staphylococcus.No vancomycin-resistant strain was identified.ESBLs-producing strains accounted for 57.1%in E.coli and 35.7%in Klebsiella spp.Isolates of Enterobacteriaceae were still sensitive to imipenem. The percentage of Pseudomonas aeruginosa and Acinetobacter baumannii strains resistant to imipenem were 9.6%and 3.0%.Pan-resistant strain was not found.Conclusions Periodic surveillance of bacterial resistance is most important and valuable for rational antimicrobial therapy.