乌苏地区近5年细菌耐药性监测分析

目的 通过对乌苏地区近5年细菌耐药性监测分析,为合理用药提供依据。方法 回顾分析2 425株病原菌的分布及耐药情况。结果 病原菌的来源以伤口分泌物、尿液和痰液为主,分布以革兰阴性(G-)杆菌为主,占51.22%,革兰阳性(G+)球菌和真菌各占45.65%和3.13%。主要的病原菌是凝固酶阴性的葡萄球菌、大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌和肠球菌等。大多数病原菌除对亚胺培南、头孢哌酮／舒巴坦敏感外(耐药率<20%),对青霉素、红霉素、克林霉素、氨苄西林和一、二代头孢菌素的耐药率超过70%,对三代头孢类和氨基糖苷类的耐药率超过30%;非发酵菌属对常用抗菌药物的耐药率普遍高于肠杆菌(除氨曲南和妥布霉素外);酶抑制剂能明显降低G-杆菌的耐药率;多重耐药菌呈逐年上升趋势;未发现万古霉素耐药株。结论 乌苏地区近5年细菌耐药形势严峻,临床应结合本地耐药监测结果,合理选择抗菌药物,以防止耐药的孳生扩散。

Germ tolerance monitoring analysis in WuSu district during the past 5 years

Objective To monitor and analyze the germ tolerance in WuSu district during the past 5 years,and to provide the basis of using antibacterial drugs effectively and correctly.Methods The distribution and drug resistance of 2 425 strains of pathogenic bacteria were analyzed retrospectively.Results Pathogenic bacteria′s main resource were oral secretion,sputum and urine.The distribution of pathogenic bacteria was main Gram-negative bacilli (51.22%),Gram-positive coccus and fungus each accounted for 45.65% and 3.13%.Main bacteria were coagulase-negative Staphylococci,E.coli,Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginosa,Acinetobacter baumannii,enterococcus and so on.Drug sensitivity assay indicated that in the most pathogenic bacteria had the highest drug resistance (resistance rate>70%) to penicillin,erythromycin,clindamycin,ampicillin,cephalosporin,two generation cephalosporin,had the resistance (resistance rate>30%) to third-generation cephalosporin and aminoglycosides,and had the most sensitivity (resistance rate<20%) to imipenem and cefoperazone.The resistance rate of non-fermenting bacteria to antibacterial agents was generally higher than that of Enterobacteriaceae (except Aztreonam and Tobramycin).Enzyme inhibitors could significantly reduce the resistance rate of Gram-negative bacilli.Multiple drug-resistant bacteria were in upward trend of yearly.Vancomycin resistant strain was not found.Conclusion The situation of bacterial resistance is grim in WuSu district during the Past 5 years.The clinical selection of antibiotics should be combined with the results of local drug resistance monitoring to prevent the breeding and diffusion of drug resistance.