摘要
目的了解2010年西北地区医院临床分离菌构成以及对常用抗菌药物的耐药性。方法西北10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CLSI 2010年标准,采用WHO-NET5.5软件进行统计分析。结果共分离细菌17 101株,革兰阳性菌占29.4%,革兰阴性菌占70.6%;葡萄球菌属中MRSA和MRCNS检出率分别为56.5%和77.4%,未发现万古霉素、替考拉宁和利奈唑胺耐药株;肠球菌属中粪肠球菌对多数测试药物的耐药率低于屎肠球菌,屎肠球菌和粪肠球菌对万古霉素的耐药率为0.2%、0.4%;对替考拉宁的耐药率为0.6%、0,无利奈唑胺耐药株;大肠埃希菌和肺炎克雷伯菌产ESBLs株分别为74.0%和46.2%,肠杆菌科细菌对碳青霉烯类抗菌药物仍高度敏感,敏感率97.5%～100.0%;鲍氏不动杆菌对亚胺培南和美罗培南的耐药率为41.4%和45.9%,铜绿假单胞菌对两者的耐药率为26.0%和22.5%;米诺环素对嗜麦芽寡养单胞菌有良好的抗菌活性,敏感率为97.2%。结论西北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 resistance of clinical isolates in northwest China in 2010. METHODS Ten hospitals participated this program.Bacterial susceptibility test was performed using Kirby-Bauer method or automated bacterial identifying system.Results were analyzed by WHONET5.5 software referring to the breakpoints of CLSI 2010. RESULTS Of 17 101 clinical isolates,Gram-positive cocci and Gram-negative microorganisms accounted for 29.4% and 70.6%,respectively.Methicillin-resistant Staphylococcus（MRSA and MRCNS） were still a major problem in Staphylococci with 53.9% in Staphylococcus aureus,and 76% in coagulase negative Staphylococcus,no vancomycin,teicoplanin or linezolid resistant strains were found.The resistance rates of Enterococcus faecalis strains to most antimicrobial agents were lower than those of E.faecium,however the resistant rates to tetracycline was lower in the later.The resistant rates of E.faecium and E.faecalis to vancomycin were 0.2% and 0.4%,to teicoplanin were 0.6% and 0%,respectively.No linezolid-resistant strain was found.The extended spectrum-β-lactamases（ESBLs） positive rates in Escherichha coli and Klebsiella pneumoniae were 74.0% and 46.2%.Enterobacteriaceae was still highly susceptible to imipenem and meropenem.41.4% and 45.9%of Acinetobacter baumannii strains were resistant to imipenem and meropenem,while Pseudomonas aeruginosa being 26.0% and 22.5%,respectively.Minocycline was the most potent agent against Stenotrophymonas maltophilia with susceptible rate of 97.2%. CONCLUSION The bacterial resistance rate is still increasing in northwest area.Regular surveillance of antimicrobial resistance is valuable for having 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
2011年第23期4933-4938,共6页
Chinese Journal of Nosocomiology
