摘要
目的了解2011年西南地区医院临床分离菌构成及对抗菌药物的耐药性,为临床用药提供参考依据。方法西南地区5所医院的临床分离菌采用K-B纸片扩散法或自动化仪器法进行抗菌药物敏感试验,按CLSI2011年标准(肠杆菌科细菌对碳青霉烯类抗菌药物敏感性的判断参照2010年标准),采用WHONET 5.6软件进行统计分析。结果共分离细菌9154株,革兰阳性菌占25.8%,革兰阴性菌占74.2%;葡萄球菌属中MRSA和MRCNS检出率分别为56.9%和80.3%,未发现万古霉素、替考拉宁和利奈唑胺耐药株,肠球菌属中屎肠球菌的分离率、耐药性均高于粪肠球菌,屎肠球菌对万古霉素、替考拉宁和利奈唑胺的耐药率分别为1.9%、1.4%、0.6%,粪肠球菌分别为0.9%、0.8%、0.5%;肠杆菌科细菌对碳青霉烯类抗菌药物保持较好的敏感性,均>93.6%,铜绿假单胞菌对阿米卡星耐药率最低为18.5%,对亚胺培南和美罗培南耐药率为24.1%和22.8%,鲍氏不动杆菌对头孢哌酮/舒巴坦的耐药率最低为38.6%,对亚胺培南和美罗培南耐药率为52.2%和65.6%。结论西南地区医疗机构细菌耐药性呈增长趋势,定期进行耐药性监测有助于了解细菌耐药性,为临床用药提供参考。
OBJECTIVE To investigate the bacterial distribution and resistance of clinical isolates in southwest China in 2011 so as to provide basis for the clinical medication.METHODS Totally 5 hospitals in southwest China participated this program.The drug susceptibility testing was performed by using Kirby-Bauer method or automated system.The results were analyzed by WHONET5.6 by referring to the breakpoints of CLSI 2011（Enterobacteriaceae strains to imipenem according to CLSI 2010）.RESULTS Of 9154 clinical isolates,the gram-positive cocci and gram-negative bacteria accounted for 25.8% and 74.2%,respectively.Of all the isolated Staphylococci,the detection rates of the MRSA and MRCNS were 56.9% and 80.3%,respectively,no vancomycin,teicoplanin or linezolid-resistant strains were found.The detection and resistance rates of Enterococcus faecium strains to most antimicrobial agents were higher than those of Enterococcus faecalis.The drug resistance rates of E.faecium to vancomycin,teicoplanin and linezolid were 1.9%,1.4%,and 0.6%,while E.faecalis were 0.9%,0.8%,and 0.5%,respectively.Enterobacteriaceae was still highly susceptible to imipenem and meropenem（93.6%）.The drug resistance rates of Pseudomonas aeruginosa to amikacin,imipenem and meropenem were 18.5%,24.1% and 22.8%.The drug resistance rates of Acinetobacter baumannii to cefoperazone/sulbactam,imipenem,and meropenem were 38.6%,52.2% and 65.6%,respectively.CONCLUSION The bacterial resistance rate is still increasing in southwest China.Regular surveillance of antimicrobial resistance is valuable for understanding the trend of antimicrobial resistance and providing the guidance for clinical use of antimicrobial agents.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第22期4983-4988,共6页
Chinese Journal of Nosocomiology
基金
卫生行业科研专项项目(201002021)
