2010年医院临床分离细菌的耐药性监测

Surveillance of antibiotic resistance of clinically isolated bacteria in 2010

目的掌握医院流行细菌谱,回顾主要细菌的药敏结果,旨在指导临床合理使用抗菌药物,积极控制医院感染。方法分析2010年山东大学第二医院各类送检标本分离出病原菌的分布及耐药性,使用VITEK鉴定系统进行细菌鉴定,纸片扩散法(K-B法)进行药敏试验,微生物检验中文系统ATBPLUS Ver3.3进行数据统计分析。结果分离出的4105株病原菌中,革兰阴性杆菌为主,占57.25%;鲍氏不动杆菌对各类抗菌药物普遍耐药,耐药率较高,对氨苄西林耐药率高达99.13%;与其相反,铜绿假单胞菌对米诺环素和磺胺类药物耐药率高,对β-内酰胺类、多肽类、氨基糖苷类抗菌药物耐药率约为30.00%;大肠埃希菌对β-内酰胺类抗菌药物普遍耐药,只对头孢西丁耐药率较低,为12.04%,同时对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦耐药率低,分别为3.14%、6.28%;金黄色葡萄球菌对各类抗菌药物有较高的耐药率,特别是β-内酰胺类,耐药率>90.00%,对氨苄西林/舒巴坦耐药率仍高达81.12%;未发现耐万古霉素金黄色葡萄球菌。结论应完善抗菌药物的规范使用,加强细菌培养意识,严格医院感染病例的诊断标准,提高医院临床抗感染的质量。

OBJECTIVE To master the popular hospital bacterial spectrum,review the result of the drug susceptibility testing so as to guide the clinical reasonable use of antibiotics and active control of nosocomial infections.METHODS The distribution and drug resistance of the pathogens isolated from various specimens submitted from Second Hospital of Shandong University in 2010 were analyzed,the bacterial identification was performed by using the VITEK identification system,disk diffusion method（KB method） was used for drug susceptibility testing,and microbiological testing Chinese statistical system ATBPLUS Ver3.3 was employed for data analysis.RESULTS Of 4105 strains of pathogens isolated,gram-negative bacteria were dominated,accounting for 57.25%;Acinetobacter baumannii was resistant to various antibiotics in general,the drug resistance rate to ampicillin was 99.13%;in contrast,the drug resistance rates of Pseudomonas aeruginosa to minocycline and sulfa drugs,the drug resistance rates to β-lactam,multiple peptide,aminoglycoside antibiotics were around 30.00%;Escherichia coli was resistant to β-lactam antibiotics in general,the resistance rate to cefoxitin was 12.04%,piperacillin/tazobactam 3.14%,cefoperazone/sulbactam 6.28%;Staphylococcus aureus was resistant to various antibiotics,the drug resistance rate to β-lactam antibiotics were higher than 90.00%,sulbactam/ampicillin 81.12%;no strains of vancomycin-resistant S.aureus were detected.CONCLUSION It is necessary to reasonably use antibiotics,strengthen the awareness of bacterial culture and strictly comply the standards of diagnosis so as to improve the quality of clinical anti-infection.