摘要
目的了解2014年临床分离菌对常用抗菌药物的耐药性,为临床合理使用抗菌药物提供依据。方法采用纸片扩散法(K-B法)和琼脂稀释法对2 546株临床分离菌进行药物敏感性试验,并根据CLSI 2013年版标准判断结果。结果 2546株临床分离菌中革兰阳性菌占21.0%,革兰阴性菌占79.0%。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48.1%和76.1%。葡萄球菌属中未发现对万古霉素、替加环素和利奈唑胺耐药株。肠球菌属中粪肠球菌和屎肠球菌未发现有万古霉素和替加环素(琼脂稀释法)耐药株。大肠埃希菌、克雷伯菌属(肺炎克雷伯菌和产酸克雷伯菌)中产ESBLs的检出率分别为67.7%和27.6%。肠杆菌科细菌对碳青霉烯类抗生素仍高度敏感,大肠埃希菌、克雷伯菌属(肺炎克雷伯菌和产酸克雷伯菌)对亚胺培南的耐药率分别为0.8%和4.9%。2014年耐碳青霉烯类抗生素的肠杆菌科细菌(CRE)的检出率为2.03%(23/1 133),高于2013年的1.17%(16/1 367)。铜绿假单胞菌和鲍曼不动杆菌对碳青霉烯类抗生素(亚胺培南)的耐药率分别是13.0%和65.5%。全耐药的鲍曼不动杆菌共检出20株,占5.4%。结论细菌耐药现象仍十分严重,多重耐药和广泛耐药菌株的流行播散对临床构成严重威胁,应引起重视并采取有效的感控措施。
Objective To investigate the bacterial resistance of clinical isolated stains in 2014 for providing the basis in the clinical ra- tional use of antimicrobial agents. Methods Drug sensitivity tests were performed in 2 546 clinical isolated stains by disk agar diffu- sion method（K-B method） and agar dilution method based on the unified plan. Results were analyzed according to CLSI standard （2013）. Results In 2 546 clinical isolated stains, the gram positive cocci and gram negative bacilli accounted for 21.0% and 79.0% ,respectively. The overall prevalence was 48.1% for MRSA in Staphylococcus aureus and 76.1% for MRCNS in coagulase-nega- tive Staphylococcus. No strains were found resistant to vancomycin, teicoplanin or linezolid. No strains were found resistant to vancomy- cin, teicoplanin（ agar dilution method） from E.feacium and E.feacalis. The overall prevalence of ESBLs-producing strains was 67.7% in E. coli, and 27.6% in Kiebsiella spp （K. pneumoniae and K. oxytoca）. Enterbacteriaceae strains were highly susceptible to carbapenem antibiotics. The resistant rate to imipenem was 0.8% for E. coli strains and 4.9% for K. pneumoniae and K. oxytoca strains. The detection rate of carbapenem-resistant enterobacteriaceae （CRE） was 2.03% （23/1 133） in 2014, higher than 1.17% （ 16/1 367） in 2013. The rate of the P. aeruginosa strains resisitant to carbapenem antibiotics（imipenem） was 13.0%, and the resistant rate of Acinetobacter baumannii strains was 65.5%. Twenty strains of Acinetobacter baumannii were all drug resistant, accounting for 5.4%. Conclusion The bacterial resistance is still on the rise, and the epidemic spread of multiple drug resistance and extensively drug-resistant strains have seriously threatened the clinical, thus more attention should be paid and the effective control measures should be taken.
出处
《山西医科大学学报》
CAS
2015年第6期569-572,共4页
Journal of Shanxi Medical University
基金
国家自然科学基金资助项目(81101642)
关键词
细菌耐药性
抗菌药物
药敏试验
耐药率
bacterial resisitance
antimicrobial agent
bacterial susceptibility test
resistance rate
