2016年安徽省铜陵地区细菌耐药性监测

Surveillance of bacterial resistance in Anhui Tongling area during 2016

目的总结2016年安徽省铜陵地区临床分离细菌耐药性监测结果。方法采用纸片扩散法(Kirby-Bauer法)进行药敏试验,按美国临床和实验室标准化协会(CLSI)2016年版标准判断结果,用WHONET 5.6软件进行耐药性分析。结果2016年共收集非重复临床分离株3 680株,其中革兰阴性菌占72.7%,革兰阳性菌占27.3%。甲氧西林耐药金黄色葡萄球菌和凝固酶阴性葡萄球菌(MRSA和MRCNS)占各自菌种的30.8%和67.8%;MRSA对庆大霉素、环丙沙星、左氧氟沙星和红霉素等均高度耐药,而对呋喃妥因的耐药率仅为1.4%。未检出耐万古霉素和替考拉宁葡萄球菌。粪肠球菌和屎肠球菌对万古霉素和替考拉宁均无耐药。大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌中产超广谱β内酰胺酶(ESBL)株分别占46.5%、27.3%和20.5%。肠杆菌科细菌除肺炎克雷伯菌和沙雷菌属外,对碳青霉烯类耐药率均低于11.1%。铜绿假单胞菌对阿米卡星、哌拉西林-他唑巴坦、头孢吡肟、头孢哌酮-舒巴坦和头孢他啶的耐药率均低于8.7%。鲍曼不动杆菌对阿米卡星、头孢哌酮-舒巴坦、米诺环素和替加环素的耐药率分别为64.4%、64.7%、6.8%和1.0%,对除喹诺酮类外其他抗菌药物耐药率均≥69.6%。结论细菌耐药状况仍较严峻,应引起高度重视,需加强抗生素的合理规范使用及医院感染的控制。

Objective To investigate the antibiotic resistance of clinical isolates collected in Tongling area.Methods Antimicrobial susceptibility test was conducted by Kirby-Bauer method.All the data were analyzed according to CLSI 2016 breakpoints by WHONET 5.6 software.Results A total of 3 680 clinical isolates were collected during 2016,including gram-negative organisms(72.7%)and gram-positive organisms(27.3%).MRSA and MRCNS accounted for 30.8%and 67.8%of S.aureus and coagulase negative Staphylococcus,respectively.MRSA showed higher resistance to gentamicin,ciprofloxacin,levofloxacin and erythromycin.About 1.4%of the MRSA strains were resistant to nitrofurantoin.No vancomycin-or teicoplanin-resistant strains were found in Staphylococcus spp.or Enterococcus.About 46.5%of the K.pneumoniae isolates,27.3%of the E.coli and 20.5%of Proteus mirabilis isolates produced extended-spectrumβ-lactamases(ESBLs).Not more than 11.1%of the Enterobacteriaceae isolates except K.pneumoniae and Serratia were resistant to carbapenems.The percentage of the P.aeruginosa strains resistant to amikacin,piperacillin-tazobactam,cefepime,cefoperazone-sulbactam and ceftazidime was less than 8.7%.The percentage of the A.baumannii strains resistant to amikacin,cefoperazone-sulbactam,minocycline and tigecycline was 64.4%,64.7%,6.8%and 1.0%,respectively.At least 69.6%of the A.baumannii strains were resistant to the antibiotics tested except quinolones.Conclusions Antibiotic resistance of clinical bacterial isolates is a serious threat for clinical practice.We should pay more attention to resistance surveillance and rational use of antibiotics.