摘要
目的了解2009年广东地区细菌耐药性监测网所属22所医院临床分离株的耐药情况。方法用纸片扩散法(KB法)对26004株临床分离株作药敏试验。结果 26004株细菌中,革兰阳性菌占35.7%;革兰阴性菌占64.3%。耐甲氧西林金葡菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为58.8%和53.6%。未发现万古霉素中介株(VISA)或耐药株(VRSA)。肺炎链球菌(非脑膜炎分离株)对青霉素耐药率为2.4%。肠杆菌科细菌对碳青霉烯类保持最低耐药性。在大肠埃希菌和克雷伯菌属中,产ESBLs菌的检出率分别为47.7%和42.6%;二甲医院大肠埃希菌ESBL发生率(52.8%)高于三甲医院(45.0%)(χ2=18.2,P<0.01)。对铜绿假单胞菌耐药率最低的依次是美洛培南(16.5%)、头孢哌酮/舒巴坦(16.9%)和哌拉西林/他唑巴坦(19.0%)。对不动杆菌属耐药率最低的依次是头孢哌酮/舒巴坦(11.2%)、米诺环素(18.2%)和亚胺培南(24.3%)。与2007年本地资料相比,不动杆菌属对亚胺培南的耐药率已由7.1%增加至24.7%,其余菌种耐药性相对稳定。结论不动杆菌属对碳青霉烯类耐药问题日趋严峻。
Objective To investigate antimicrobial resistance of clinical isolates from 22 hospitals submitted to Guangdong surveillance of antimicrobial resistance in 2009. Methods Disc diffusion test （ K - B methods） was employed to study the antimicrobial resistance. WHONET 5.4 was applied for analysis. Results Of 26004 clinical isolates, Gram neg- ative bacilli and Gram positive cocci accounted for 64. 3% and 35.7%, respectively. The detection rates of methicillin - resistant strains was 58.8% in S. aureus and 53.6% in conagulase negative Staphylococcus. No VISA or VRSA isolate was found. Two point four percent S. pneumoniae isolates were penicillin -resistant （PRSP） according to 2009 CLSI criterion. The resistant rates of enterobacter to carbpenem were the lowest. The prevalence of ESBLs - producing strains in E. coli and, Klebsiella spp. isolates was 47.7% and 42. 6%, respectively. The prevalence of ESBLs -producing strains in E. coli in teaching hospitals was higher than that in community hospitals. The resistance rates of P. aeruginosa to meropenem, cefoperazone/sulbactam and piperacillin/ tazobactam were 16. 5% ,16. 9%and 19. 0%, respectively and 24. 3% , 11.2% and 34. 3% for A cinetobacter spp. , respectively. Compared with data in 2007, the resistant rates of A cinetobacter spp. to imipenem was increased from 7. 1% to 24. 7% in 2009, while other organisms kept stable resistance to antibiotics. Conclusion Emergence and spread of Acinetobacter species, resistant to most of the available antimicrobial agents, is an area of great concern.
出处
《中国临床药理学杂志》
CAS
CSCD
北大核心
2011年第7期551-556,560,共7页
The Chinese Journal of Clinical Pharmacology
关键词
细菌耐药性
抗菌药
细菌药敏试验
bacterial resistance
antimicrobial agent
bacterial susceptibility testing
