安徽省铜陵地区2010年细菌耐药性监测

Surveillance of bacterial resistance in Anhui Tongling Area during 2010

目的了解安徽省铜陵地区2010年临床分离菌株耐药状况。方法 2010年1—12月铜陵地区临床分离菌株用纸片法(Kirby-Bauer)作药敏试验。结果此期获得的2 217株细菌中革兰阳性菌498株,占22.5%;革兰阴性菌1 719株,占77.5%;MRSA和MRCNS分别占金葡菌和凝固酶阴性葡萄球菌的34.8%和75.1%;MRSA和MRCNS对庆大霉素、环丙沙星、克林霉素和红霉素等均高度耐药,未见耐万古霉素和替考拉宁葡萄球菌;粪肠球菌对青霉素、氨苄西林、呋喃妥因、磷霉素和氯霉素的耐药率较低;屎肠球菌对磷霉素和氯霉素耐药率较低,未见耐万古霉素和替考拉宁肠球菌。大肠埃希菌和克雷伯菌属中产ESBLs株分别占53.2%和39.9%,产ESBLs株除对亚胺培南和美罗培南均无耐药株外,对其他19种抗菌药物的耐药率均较非产ESBLs株高;不发酵糖革兰阴性杆菌对常用抗菌药物的耐药率较往年上升。结论未发现对糖肽类抗生素耐药的葡萄球菌属菌株;肠杆菌科细菌对亚胺培南、美罗培南、头孢哌酮-舒巴坦、哌拉西林-他唑巴坦和阿米卡星耐药率低;不发酵糖革兰阴性杆菌对常用抗菌药物的耐药率较往年上升,应加强抗菌药物的合理使用和医院感染控制。

Objective To investigate the bacterial resistance of clinical isolates collected in Tongling area.Methods Antimicrobial susceptibility test was conducted by Kirby-Bauer method.Results Of the 2 217 clinical isolates,gram positive organisms accounted for 22.5%,gram negative organisms 77.5%.MRSA and MRCNS accounted for 34.8% and 75.1% of S.aureus and coagulase negative Staphylococcus,respectively.MRSA and MRCNS showed higher resistance to gentamicin,ciprofloxacin,clindamycin and erythromycin than methicillin-susceptible strains.No vancomycin-or teicoplanin-resistant strain of Staphylococcus spp.was identified.The resistance rate of E.faecalis to penicillin,ampicillin,nitrofurantoin,fosfomycin and chloramphenicol was low.E.faecium was relatively less resistant to fosfomycin and chloramphenicol.No strain of Enterococcus spp.was identified as vancomycin-or teicoplanin-resistant.About 53.2% of E.coli isolates and 39.9% of Klebsiella isolates produced extended-spectrum β-lactamases（ESBLs）.The resistance rates of ESBLs-producing strains to 19 antimicrobial agents were much higher than those of ESBLs non-producing ones.No imipenem or meropenem-resistant isolate was found.The resistance rate of non-fermenters was higher than the rate of last year.Conclusions Gram positive isolates were relatively less resistant to glycopeptides.Enterobacteriaceae strains were relatively less resistant to imipenem,meropenem,cefoperazone-sulbactam,piperacillin-tazobactam or amikacin.The resistance rate of non-fermenters was higher than the rate of last year.It is mandatory to take effective antibiotic policy and infection control measures.