2009～2011年凉山州常见临床分离菌及其耐药性

Common clinical bacterial isolates and their drug resistance during 2009 to 2011 in Liangshan

目的掌握凉山州常见临床分离菌及其耐药性。方法按照《全国临床检验操作规程》进行细菌培养,普通细菌鉴定及药敏试验用MicroscanPC20阳性、NC31阴性复合板,苛氧菌药敏试验用K-B法。统计2009年7月1日至2011年6月30日相关资料。结果临床分离可疑病原菌2 565株,其中革兰阳性菌745株(29.1%),革兰阴性菌1 468株(57.2%),假丝酵母菌186株(7.3%),泌尿生殖道支原体166株(6.4%)。革兰阳性菌前5位为金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌、屎肠球菌、粪肠球菌。革兰阴性菌前5位为大肠埃希菌、鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、阴沟肠杆菌。鲍曼不动杆菌对亚胺培南敏感率下降至35.5%,铜绿假单胞菌对阿米卡星敏感率下降至42.0%、哌拉西林/他唑巴坦敏感率下降至45.4%。泛耐药鲍曼不动杆菌检出率为64.5%、耐甲氧西林金黄色葡萄球菌为62.0%、耐甲氧西林凝固酶阴性葡萄球菌为90.5%、产超广谱β-内酰胺酶大肠埃希菌77.9%、产超广谱β-内酰胺酶肺炎克雷伯菌为75.5%。结论常见临床分离菌耐药形势严峻,合理选用抗菌药物,加强感染控制是当务之急。

Objective To understand the common clinical bacterial isolates and their drug resistance in Liangs- han Prefecture. Methods Based on the National Clinical Tests＇ Rules and Procedures, bacterial cultivation was car- ried out. Microscan PC20 and NC31 composite boards were used to identify the common bacteria and test their drug sensitivity, while K-B method was used to judge obligate aerobic bacteria. Statistics of related materials recorded during July 1st, 2009 to June 30th, 2011 were reviewed. Results 2 565 clinically suspected pathogenic strains were isolated, including 745 strains of Gram-positive bacteria, accounting for 29.1%, 1 468 strains of Gram-negative bac- teria, accounting for 57.2%, 186 strains of Candida fungi, accounting for 7.3% and 166 strains of Genitourinary tract mycoplasma, accounting for 6.4 %. The first five bacteria ranking in the amount of Gram-positive bacteria were Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus haemolyticus and Enterococcus faecalis, while the first five among Gram-negative bacteria were Escherichia coli, Acinetobacter bau- mannii, Pseudomonas aeruginosa, Klebsiella pneumoniae and Enterobacter cloacae. The sensitivity rate of Acineto- bacter baumannii tO Imipenem decreased to 35.5 %. The sensitivity rate of Pseudomonas aeruginosa bacteria to Ami- kacin decreased to 42.0% and to Piperacillin decreased to 45.4%. The isolation rate of Acinetobacter baumannii with extensive drug resistance was 64.5 %, of methicillin resistant staphylococcus aureus was 62.0%, of methicillin re- sistant coagulase negative staphylococcus was 90.5 %, of Escherichia coli with extend-spectrum β-1actamases （ES- BLs） was 77.9% and of Klebsiella pneumonia with ESBLs was 75. 5%. Conclusion The situation of the bacterial drug resistance of the common clinical isolates might be very serious. It might be urgent to use antibacterial drugs properly and to strengthen infection control.