摘要
目的了解北京协和医院2014年临床分离细菌对抗菌药物的耐药性。方法共收集8 295株非重复分离菌,采用纸片扩散法或自动化仪器法进行药敏试验,按CLSI 2014年版标准判读药敏结果,采用WHONET 5.6软件进行数据分析。结果 8 295株细菌中,革兰阴性菌占67.4%,革兰阳性菌占32.6%。10种最常见的细菌分别为:大肠埃希菌(18.1%),铜绿假单胞菌(10.8%),肺炎克雷伯菌(10.2%),金黄色葡萄球菌(金葡菌)(9.8%),鲍曼不动杆菌(9.2%),粪肠球菌(6.3%),屎肠球菌(4.1%),凝固酶阴性葡萄球菌(4.1%),阴沟肠杆菌(3.1%)和嗜麦芽窄食单胞菌(2.9%)。耐甲氧西林金葡菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)的检出率分别为28.4%和66.5%。耐甲氧西林葡萄球菌对β内酰胺类和其他抗菌药物的耐药率明显高于甲氧西林敏感葡萄球菌。仍有81.3%MRSA对甲氧苄啶-磺胺甲噁敏感。MRCNS中有81.1%菌株对利福平敏感。未发现对万古霉素、替考拉宁和利奈唑胺耐药的葡萄球菌。粪肠球菌对大多数抗菌药物(除外氯霉素)的耐药率明显低于屎肠球菌。发现少数万古霉素耐药肠球菌(VRE),根据表型推测为Van A和Van B型耐药,未发现对利奈唑胺耐药的肠球菌。β溶血链球菌对青霉素的敏感率为90.8%。产ESBL的大肠埃希菌、克雷伯菌属(肺炎克雷伯菌和产酸克雷伯菌)和奇异变形杆菌的检出率分别为54.2%、31.0%和28.9%。肠杆菌科细菌对碳青霉烯类仍高度敏感,总耐药率≤3.3%。广泛耐药肺炎克雷伯菌的检出率为1.3%。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为17.5%和11.8%,对阿米卡星的耐药率5.9%。鲍曼不动杆菌对上述2种碳青霉烯类抗生素的耐药率分别为69.0%和67.4%,对头孢哌酮-舒巴坦和米诺环素的耐药率低,分别为47.8%和28.7%。广泛耐药鲍曼不动杆菌和铜绿假单胞菌的检出率分别是32.3%和1.8%。流感嗜血杆菌中β内酰胺酶的检出率为33.7%。肺炎链球
Objective To investigate the antimicrobial resistance profile in the clinical bacterial strains isolated from Peking Union Medical College Hospital during 2014. Methods A total of 8 295 nonduplicate clinical isolates were collected. Disc diffusion test （Kirby-Bauer method） and automated systems were employed to study the antimicrobial susceptibility. The data were analyzedby using WHONET 5.6 software according to CLSI 2014 breakpoints. Results Of the 8 295 isolates, 67.4% were gram-negative, and 32.6% were gram-positive. The top 10 most frequently isolated bacteria were： E. coli （18.1%）, P. aeruginosa （10.8%）, K. pneumoniae （10.2%）, S. aureus （9.8%）,A. baumannii （9.2%）, E, faecalis （6.3%）, E. faeeium （4.1%）, coagulase-negative Staphylococcus （4.1%）, E. cloacae （3.1%） and S. maltophilia （2.9%）. Methicillin resistant strains in S. aureus （MRSA） and coagulase negative Staphylococcus （MRCNS） accounted for average of 28.4% and 66.5%, respectively. The resistance rates of MR strains to β-1actams and other antimicrobial agents were much higher than those MS strains. Overall, 81.3% of MRSA strains were still susceptible to trimethoprim-sulfamethoxazole, while 81.1% of MRCNS strains were susceptible to rifampin. No staphylococcal strains were resistant to vancomycin, teicoplanin or linezolid. The resistance rate of E. faecalis strains to most of the drugs tested （except chloramphenicol） was much lower than those of E. faecium. Several strains of both E. faecium and E. faecalis were found resistant to vancomycin and teicoplanin, which were Van-A and Van-B types based on their phenotype. No linezolid resistant enterococcal strains were found. Data showed that 90.8% of 13-hemolytic Streptococcus strains were susceptible to penicillin. ESBLs-producing strains accounted for 54.2%, 31.0% and 28.9% in E. coli, Klebsiella spp （K. pneumoniae and K. oxytoca） and P. mirabilis, respectively. Enterobacteriaceae isolates were still highly susceptible to carbapenems. Overall
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2016年第3期315-322,共8页
Chinese Journal of Infection and Chemotherapy
关键词
细菌耐药性监测
碳青霉烯类耐药肠杆菌科细菌
广泛耐药菌
药敏试验
bacterial resistance surveillance
carbapenem-resistant Enterobacteriaceae
extensively-drug resistant
antimicrobialsusceptibility testing
