2011年包头地区细菌耐药性监测

Surveillance of Bacterial Resistance in Baotou Area in 2011

目的:了解包头地区2011年临床分离病原菌对常用抗菌药物的耐药状况,为临床合理应用抗菌药物提供依据。方法:收集包头地区6家三级综合医院2011年临床送检标本分离菌株及药敏试验数据,根据美国临床实验室标准化协会(CLSI)2010年标准判断结果,采用WHONET 5.5软件完成统计分析。结果:共分离出病原菌5 257株,其中革兰阴性菌3 906株(占74.3%),以大肠埃希菌、克雷伯菌属、铜绿假单胞菌、不动杆菌属、肠杆菌属多见,产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌属的检出率分别为65.4%和39.7%;革兰阳性菌1 351株(占25.7%),以凝固酶阴性葡萄球菌、金黄色葡萄球菌、肠球菌属、肺炎链球菌多见,其中金黄色葡萄球菌和凝固酶阴性葡萄球菌中甲氧西林耐药株的检出率分别为46.3%和72.1%。亚胺培南对革兰阴性杆菌仍保持较强的抗菌作用,万古霉素、替考拉宁、利奈唑胺对革兰阳性球菌仍保持较强的抗菌作用,未检出耐万古霉素、替考拉宁、利奈唑胺的葡萄球菌属菌株。结论:本地区细菌耐药性较为严重,应该严格执行《抗菌药物临床应用指导原则》,根据病原菌种类、细菌药敏试验结果以及抗菌药物的适应证选择抗菌药物,以保证抗菌药物的合理应用。

OBJECTIVE：To investigate the resistance of clinical isolates to commonly used antibiotics in Baotou area in 2011,and to provide reference for the rational use of antibiotics.METHODS：Strains isolated from 6 third-grade general hospitals of Baotou area in 2011,and the data of susceptibility test were collected.WHONET 5.5 software was used for data analysis according to 2010 CLSI breakpoints.RESULTS：After analyzing clinical isolates from 6 third-grade general hospitals of Baotou area,a total of 5 257 clinical strains were collected in 2011,of which 3 906 strains of Gram-negative bacterium accounted for 74.3%,Escherichia coli,Klebsiella spp,Pseudomonas aeruginosa,Acinectobacter app,Enterobacter spp as the most common strains.The prevalence of ESBLs producing strains was 65.4% in E.coli and 39.7% in Klebsiella spp;1 351 strains of Gram-positive bacterium accounted for 25.7%,coagulase negative Staphylococcus,Staphylococcus aureus,Enterococcus spp,Streptococcus pneumoniae as the most common strains.The prevalence of Methicillin-resistant strains was 46.3% in S.aureus and 72.1% in coagulase negative Staphylococcus.Imipenem was still sensitive to Gram-negative bacterium.Gram-positive organisms showed highest susceptibility to vancomycin,teicoplanin and linezolid.There was no Staphylococcus spp resistant to vancomycin,teicoplanin and linezolid.CONCLUSIONS：The drug resistance of clinical isolated strains is serious in Baotou area.We must strictly enforce Guiding Principles of Clinical Use of Antibiotics.Antibiotics should be used according to the type of pathogenic bacteria,drug sensitivity test and indications in order to guarantee rational use of antibiotics.