摘要
目的了解2008年度全国89家医院中伤口感染处样本分离的细菌分布情况及对各类抗菌药物的耐药性。方法药物敏感性试验采用纸片扩散法,耐药性数据分析采用WHONET 5.4软件进行统计分析。结果共收集临床伤口感染处样本分离细菌3388株,其中革兰阴性杆菌占50.5%,革兰阳性球菌占45.5%;前6位的菌种为凝固酶阴性葡萄球菌(CNS)(18.9%),金黄色葡萄球菌(16.1%),大肠埃希菌(14.4%),铜绿假单胞菌(10.1%),肠球菌属(8.3%),不动杆菌属(7.2%)。体外药物敏感性试验结果显示β-溶血链球菌未见青霉素耐药菌株;耐甲氧西林金葡菌(MRSA)和凝固酶阴性葡萄球菌分别为32.0%和74.6%。耐万古霉素的粪肠球菌为0.7%,屎肠球菌为3.5%。大肠埃希菌超广谱β-内酰胺酶产酶率为53.3%,肺炎克雷伯菌为25.8%,变形菌属为5.4%,发现对亚胺培南耐药的肺炎克雷伯菌和肠杆菌属各1株。伤口感染已出现铜绿假单胞菌和不动杆菌属多重耐药株。结论定期进行耐药性监测有助于了解伤口感染细菌耐药性变迁,为临床经验用药提供理论依据。
Objective To investigate the distribution and antibiotic resistance of clinical isolates bacteria from wound infections in 89 China hospital during 2008. Methods Antimicrobial susceptibility testing of clinical isolates was carried out by Kirby-Bauer methods and data were applied for analysis by WHONET5.4. Results 3388 clinical strains were isolated from wound infections, Gram positive cocci accounted for 45.5%, and gram negative bacilli 50.5%. The most predominant pathogens were coagulase-negative Staphylococcus（18.9%）, Staphylococcus aureus（16.1%）, Escherichia coli（14.4%）, Pseudomonas aeruginosa（10.1%）, Enterococcus sp. （ 8.3 %）, Acinetobacter spp（7.2%）. The drug resistance results show that no penicillin resistant β-haemolytic streptococci were found; The detection rates of methicillin-resistant staphylococci were 32.0% in staphylococci aureus and 74.6% in coagulase-negative Staphylococcus. Vancomycin resistance Enterococeus in Enterococcusfaecalis was 0.7% and in Enterococcusfaecium was 3.5%. ESBLs-producing strains accounted for 53.3% in E. coli, 25.8% in Klebsiella spp. and 5.4% in Proteus mirabilis. One Klebsiella pneumoniae and one Enterobacter were found to be resistant to imipenem. A number of multiple resistant strains appeared in Pseudomonas aeruginosa and Acinetobacter spp. in wound infections. Conclusions Monitoring the resistance to antibiotics of the bacteria in wound infections is most important and valuable, which provides practical guidance of rational selection of antimicrobial agents for clinicians.
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2010年第8期602-608,共7页
Chinese Journal of Antibiotics
