摘要
目的 分析多重耐药菌（MDRB）的分布特点及耐药性。方法 采用法国生物梅里埃ATB鉴定仪进行病原菌鉴定,K-B纸片扩散法进行药敏试验,同时根据来源追踪分析其易感因素。结果 9954份标本中检出MDRB 811株,检出率8.1%;主要MDRB为大肠埃希菌、凝固酶阴性葡萄球菌、克雷伯菌、金黄色葡萄球菌、鲍曼不动杆菌、铜绿假单胞菌,后两者出现泛耐菌株;标本来源以呼吸道标本为主,占47.8%,主要分布于ICU病房,占41.8%;多重耐药肠杆菌对碳青霉烯类抗菌药物仍高度敏感,总耐药率〈1.5%,对阿米卡星和酶抑制剂药物耐药率〈30.0%;多重耐药非发酵菌则对碳青霉烯类抗菌药物总耐药率〉77.0%,但对多黏菌素100.0%敏感和对头孢哌酮/舒巴坦保持较大的活性（耐药率〈20.0%）;多重耐药葡萄球菌对万古霉素、替考拉宁和利奈唑胺100.0%敏感,对氯霉素和利福平的耐药率相对较低（〈30.0%）;MDRB对其它抗菌药物呈现较高水平耐药;其易感因素包括高龄、基础疾病多、住院时间超过2周、使用多种广谱抗生素特别是三代头孢超过7 d以上以及各种有创操作。结论 MDRB对常用抗菌药物耐药严重,临床医生应高度重视病原学检查和它们之间的耐药谱差异,根据药敏试验结果合理应用抗菌药物。
Objective To provide an effective basis for clinical control methods of multi-drug-resistant bacterial （MDRB） infections by analyzing the distribution and antimicrobial resistance of MDRB.Methods The French Merieux ATB Expression Automated Analysis System was used for bacterial identification,whereas a drug susceptibility testing was performed by K-B methods.Drug-resistance rate was calculated,and the predisposing factors were analyzed.Results Altogether 811（8.1%） strains were isolated from 9954 specimens,and the majority of multiply antimircobial-resistant bacteria were Escherichia coli,Coagulase-negative staphylococci,Klebsiella Pneumoniae Staphylococcus aureus,Acinetobacter Baumannii,Pseudommonas aeruginosa,whereas the last two appeared pan resistant strains.Specimen source was mainly from respiratory specimens,accounted for 47.8%,and was mainly distributed in the ICU unit,atout41.8%;MDRB enterobacter was highly sensitive to Carbapenems with resistance rates less than 1.5% and to Amikacin and other inhibitor drugs that rate was less than 30.0%.The resistance rates of MDRB non-fermentative bacteria was 〉77.0% to Carbapenem antibacterial drugs whereas to non-resistance was found to polymyxin and only 20.0% resistance rate to Cefoperazone/sulbactam.MDRB staphylococcus was 100.0%sensitive to Vancomyci,Teicoplanin and Linezolid and less sensitive（〈30.0%） to chloramphenicol and rifampicin.MDRB showed high resistance rate to other antibacterial drugs.The predisposing factors included age,other disease,hospitalization over two weeks,the usage of multiply antimicrobial especially cephalosporins overtoppinh 7 days,and invasive operations. Conclusion The major MDRBs are resistant to common-used antimicrobial drugs.It is nesessary to pay attention to the differences.
出处
《中国基层医药》
CAS
2013年第1期26-28,共3页
Chinese Journal of Primary Medicine and Pharmacy
基金
广东省江门市科技立项项目（201111）
