2008至2010年3年细菌的耐药监测研究

Surveillance of antimicrobial resistance in clinical isolates in our hospital from 2008 to 2010

目的分析2008至2010年本院3年临床分离菌的耐药情况。方法用纸片扩散法进行抗菌药物敏感实验,根据CLSI标准用WHONET 5.4软件进行数据分析。结果 3年临床分离的4916株病原菌中,革兰阳性菌占22.7%,革兰阴性菌占77.3%;3年耐甲氧西林金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)总检出率分别为59.3%,89.5%。大肠埃希菌、肺炎克雷伯菌超广谱β内酰胺酶(ESBLs)总检出率分别为57.5%,34.6%。鲍曼不动杆菌对碳青霉烯类抗菌药物的耐药率有逐年上升趋势,而铜绿假单孢菌则有下降趋势。结论革兰阳性菌对万古霉素、替考拉宁、利奈唑胺均敏感;肠杆菌科细菌对碳青霉烯类药物耐药率较低,但产ESBLs肠杆科细菌较不产ESBLs肠杆科细菌耐药严重;鲍曼不动杆菌对常见抗菌药物的耐药率高,且明显高于铜绿假单孢菌。

Objective To analyze the tendency and antimicrobial resist- ance of clinical isolates in our hospital from 2008 to 2010. Methods Disk diffusion method was used to determine the antimicrobial suscepti- bility. And the WHONET 5.4 software was used to analyze the data based on the annual CLSI. Results Of 4916 clinical isolates, gram - positive organisms accounted for 22.7% , and gram - negative organisms 77.3 %. The detection rates of methicillin - resistant Staphylococcus au- reus （ MRSA ） and coagulase - negative staphylococci （ MRCNS ） were 59.3% and 89.5% ,respectively. Total extended - spectrum 13 lactamas- es （ESBLs） - producing Escherichia coli and Klebsiella spp were accounted for 57. 5% and 34. 6%, respectively. The carbapenem resistance rate in Acinetobacter Spp has increased year by year. There was a decreased tend- ency for the carbapenem resistance rate in Pseuclomonas aeruginosa. Con- clusion Gram -positive bacteria are still susceptible to the vancomycin teicoplanin and linezolid. Enterbacteriaceae bacteria are still very sensitive to carbapenems. But, the ESBLs -producing strains in Enterobacteriaceae are more resistant than none strains. Acinetobacter baumannii are more drug resistant, comparing to Pseudomonas aeruginosa.