武汉地区病原菌耐药性监测

Monitoring of bacterial resistance in Wuhan

目的了解武汉地区临床分离病原菌对常见抗菌药物的耐药性,为抗菌药物的临床合理应用提供依据。方法收集武汉地区20所医院2011年9月1日-2012年9月1日临床分离的细菌,采用纸片扩散法或自动化仪器法对临床分离病原菌进行药敏试验,依据CLSI 2010年标准,采用WHONET5.6软件进行统计分析。结果共分离病原菌18 384株,革兰阳性菌占31.95%,革兰阴性菌占68.05%;MRSA检出率为32.22%,未发现万古霉素耐药株;大肠埃希菌、肺炎克雷伯菌和奇异变形菌中产ESBLs检出率分别为47.78%、39.10%、23.43%;铜绿假单胞菌对阿米卡星耐药率最低,为15.67%,鲍氏不动杆菌对替卡西林/克拉维酸耐药性最低,为23.53%。结论武汉地区临床分离病原菌耐药较严重,定期进行耐药性监测有助于了解病原菌耐药性,为临床合理使用抗菌药物提供科学依据。

OBJECTIVE To investigate the drug resistance of clinical isolates to common antibiotics so as to guide the clinical medication . METHODS Totally 20 hospitals in Wuhan participated in this program . The drug susceptibility testing was performed with K-B method or automated system .The results were analyzed by WHO-NET5 .6 according to CLSI 2010 .RESULTS A total of 18384 clinical isolates were collected ,the gram-positive bacilli and the gram-negative bacilli accounted for 31 .95% and 68 .05% respectively .The detection rate of MRSA was 32 .22% ,no vancomycin-resistant strains were found .The detection rates of ESBLs-producing Escherichia coli ,K lebsiella pneumonia and P .mirabilis were 47 .78% ,39 .10% ,23 .43% ,respectively .The drug resistance rate of Pseudomonas aeruginosa to amikacin was 15 .66% .The drug resistance rate of Acinetobacter baumannii to ticarcillin/clavulanic acid was 23 .50% .CONCLUSION The drug resistance of the pathogenic bacteria isolated from Wuhan is serious , regular surveillance of antimrobial resistance is necessary for understanding the trend of antimrobial resistance and providing the guidance for clinical use of antimrobial agents .