2009-2011年阜阳地区常见病原菌分布和耐药性分析

Distribution and drug resistance of common pathogenic bacteria in Fuyang area from 2009 to 2011

目的分析阜阳地区2009—2011年细菌分布及耐药性流行趋势。方法采用2009年美国临床实验室标准协会（CLSI）推荐的琼脂对倍稀释法进行抗菌药物敏感试验，计算抗菌药物的耐药率。结果临床分离出2673株革兰阴性菌和787株革兰阳性菌，检出率在前5位的细菌分别为大肠埃希菌（20．4％）、鲍曼不动杆菌（16．9％）、铜绿假单胞菌（14．4％）、肺炎克雷伯菌（9．5％）、阴沟肠杆菌（6．8％）。未检测到耐万古霉素的葡萄球菌和肠球菌，2011年检出1例耐替考拉宁的屎肠球菌。大肠埃希菌和肺炎克雷伯菌的耐药率均较高（均〉50％），铜绿假单胞菌和鲍曼不动杆菌的对亚胺培南和美罗培南的耐药率均较高（15．7％～44．1％）。结论阜阳地区的细菌感染仍以革兰阴性菌为主，多重耐药菌感染严重，抗菌药物的耐药率逐年上升，临床应根据细菌培养结果合理选用抗菌药物，并需加强抗菌药物的管理。

Objective To analyze the distribution and the bacteria resistance in Fuyang from 2009 to 2011. Methods The agar diffusion test was used to conduct the antimicrobial drug sensitive experiment. The resistant rate was calculated according to the criteria recommended by the guidelines of CLSI （2009）. The resistance of antimicrobial drug was calculated. Results A total of 2 673 Gram-negative bacteria and 787 Gram-positive bacteria were isolated from clini- cal samples. The detection rates of the top five bacteria were Escherichia coli （20. 4% ）, Acinetobacter baumannii （ 16. 9% ） , Pseudornonas aeruginosa（ 14. 4% ） , Klebsiella pneumoniae（ 9. 5% ） , and Enterobacter cloacae（6. 8% ）. There were no Staphylococcus aureus and Enterococcus resistant to vancomycin in the study. There was a strain of Enterococcusfae- cium that was resistant to teicoplanin in 2011 annual inspections. The rates of drug resistance in Escherichia coli and Kleb- sieUa pneumoniae were higher than 50% , and they were highly sensitive to the imipenem and meropenem. The resistance rates of imipenem and meropenem in P. aeruginosa and A. baumannii were high （ 15.7 % -44. 1% ）. Conclusions Gram- negative bacteria is main bacterial phathogen in Fuyang area. It is severe that bacteria were resistant to multiple antimicro- bial drugs. Resistance rates of antibiotic increased year by year. Clinicians should be aware of this possibility, select anti- biotics according to the results of the bacterial culture and strengthen the management of antibiotics.