2015年广州珠江医院细菌耐药性监测

Report of bacterial resistance surveillance in Zhujiang Hospital in 2015

目的了解南方医科大学珠江医院2015年临床分离菌对常用抗菌药物的敏感性和耐药性。方法采用纸片扩散法或自动化仪器法进行细菌药物敏感性试验。结果收集2015年1-12月临床分离菌共4 229株,革兰阳性菌1 541株(36.4%),革兰阴性菌2 688株(63.6%)。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检出率分别为47.2%和76.4%。甲氧西林耐药株(MRSA和MRCNS)对β内酰胺类抗生素和其他测试药的耐药率均显著高于甲氧西林敏感株(MSSA和MSCNS)。94.0%MRSA菌株对甲氧苄啶-磺胺甲唑敏感;83.1%MRCNS菌株对利福平敏感。未发现对万古霉素、替考拉宁和利奈唑胺耐药的葡萄球菌。肠球菌属中粪肠球菌对多数抗菌药物的耐药率显著低于屎肠球菌,未发现对万古霉素和替考拉宁耐药的菌株。大肠埃希菌和克雷伯菌属中产超广谱β内酰胺酶(ESBL)株分别为52.6%和39.7%,产ESBL株对测试药物的耐药率均比非产ESBL株高。肠杆菌科细菌对碳青霉烯类抗生素仍高度敏感,绝大多数菌株耐药率低于4.0%。不动杆菌属对亚胺培南和美罗培南的耐药率分别为69.2%和71.2%。结论该医院细菌耐药性仍呈增长趋势,多重耐药和广泛耐药菌株检出率的增加对临床抗感染治疗构成严重威胁,需及时采取有效的感控措施。

Objective To investigate the susceptibility profile Methods Susceptibility test was carried out using Kirby-Bauer method of clinical isolates in Zhujiang Hospital in 2015. or automated systems. Results A total of 4 229 clinical isolates were isolated from January to December 2015, including 2 688 （63.6%） gram negative and 1 541 （36.4%） gram positive bacteria. Methicillin-resistant S. aureus （MRSA） and coagulase-negative Staphylococcus （MRCNS） accounted for 47.2% and 76.4%, respectively. The methicillin-resistant strains have much higher resistance rates to beta-lactams and other antirnicrobial agents than methicillin-susceptible strains. Majority （94.0%） of MRSA strains were susceptible to trimethoprim-sulfamethoxazole, and 83.1% MRCNS strains were susceptible to rifampin. No staphylococcal isolates were found resistant to vancomycin, teicoplanin or linezolid. E. faecalis strains showed much lower resistance rate to most of the drugs tested （except chloramphenicol） than E. faecium. No enterococcal isolates were found resistant to vancomycin or teicoplanin. ESBLs were produced in 52.6% of E. coli and 39.7% of Klebsiella （K. pneumoniae and K. oxytoca） strains. ESBLs-producing Enterobacteriaceae strains had higher resistance rates to common antimicrobial agents than non-ESBLs-producing strain. Enterobacteriaceae isolates were highly susceptible to carbapenems,（（4% resistant）. Acinetobacter spp. strains showed high resistance to imipenem （69.2% resistant） and meropenem （71.2% resistant）. Conclusions The antibiotic resistance is still increasing in this hospital. The emerging multi-drug or pan-drug resistant strains pose a serious threat to clinical practice and implies the importance of strengthening infection control.