2000年湖北省临床细菌耐药性监测报告

Surveillance of CHnical Bacterial Resistance in Hubd Province in 2000

目的 探讨2000年湖北省临床分离菌对抗菌药物的耐药状况。方法 将湖北地区15所医院纸片扩散法药敏试验的抑菌环直径输入计算机。根据1999年美国临床实验室标准委员会颁布的准则,采用“WHONET-5”软件完成统计分析。结果 临床10 241株分离菌中,最常见的菌种依次为凝固酶阴性葡萄球菌、大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、克雷伯菌属、肠球菌属、肠杆菌属,不动杆菌属等。22.0％的金黄色葡萄球菌和69.9％的凝固酶阴性葡萄球菌对苯唑西林耐药,对其他药物的耐药率也高。肠球菌中万古霉素耐药株分别占粪肠球菌和屎肠球菌的3.1％和1.9％。亚胺培南、头孢他啶、阿米卡星、环丙沙星、哌拉西林、头孢噻肟对革兰阴性菌(包括肠杆菌科及非发酵菌)有良好抗菌活性,但与1996年、1999年监测资料比较,敏感率逐年下降。结论 临床细菌耐药性日益严重,应在不同地区开展耐药性监测工作,强调临床合理应用抗菌药物。

Objective To report the surveillance data on bacterial resistance in Hubei hospitals.Methods The diameters of the inhibition zone of clinical bacterial around antibiotic susceptibility test discs in IS Hubei province hospitals were computerfiled and analysed by the software of 'WHONET- 5' according to NCCLS published in 1999.Results A total of 10241 clinical isolates were collected from January 1 to December 31, 2000. Coagulase negative staphylococci (CNS), E.Coli, P.aeruginosa, S.areus, Klebsiel-la spp, Enterococcus spp, Enterobacter spp, Acinetobacter spp were the main microorganisms.Oxacillin resistant strains accounted for 22.0% and 69.9% of S.aureus and CNS respectively; In Enterococcus spp.vancomycin resistant strains accounted for 3.1% and 1.9% of E.fecalis and E.fecium, respectively.Imipenem ceftazidime, amikacin, ciprofloxacin, piperacillin and cefotaxime were the most active agents against Gram - negative organisms including Enterobacteriaceae and glucose nonfermenters, while the susceptible rates were significantly lower as compared with the data in 1996 and 1999.Condutions The results suggested that it is an urgent need for surveillance of bacteria resistance in different districts and rational use of antimicrobial agents should be emphasized during clinical therapy.