2006～2008年医院感染病原菌分布及耐药性分析

目的 分析2006～2008年临床感染病原菌的分布及耐药性变化,为临床合理用药提供依据.方法 药敏试验采用K-B法,WHONET5.4软件进行数据统计分析.结果 排在前3位的革兰阳性球菌分别是金黄色葡萄球菌、粪肠球菌、屎肠球菌,其中敏感率保持>98.0%抗菌药物为利奈唑胺、万古霉素和替考拉宁,而其他常用抗菌药物敏感率<50.0%;其中耐甲氧西林金黄色葡萄球菌(MRSA)的分离率分别为60.0%、61.2%和65.2%;排在前3位的肠杆菌科细菌主要为大肠埃希菌、肺炎克雷伯菌、产酸克雷伯菌,对亚胺培南敏感率最高,产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌3年分别为49.1%、51.2%、58.2%和46.6%、60.0%、67.9%;非发酵菌排在前3位的分别为铜绿假单胞菌、鲍氏不动杆菌、洋葱伯克霍尔德菌,抗菌药物敏感率最高的为头孢哌酮/舒巴坦,多药耐药菌(MDR)的分离率均>50.0%.结论 万古霉素、替考拉宁、利奈唑胺对革兰阳性球菌始终保持高活性;碳青酶烯类仍然是肠杆菌科细菌活性最高的药物;多药耐药铜绿假单胞菌和鲍氏不动杆菌有逐年增加的趋势;MRSA、ESBLs的分离率逐年增加,值得关注.

Antimicrobial Resistance Analysis and Microbial Distribution in Xi'an Region 2006-2008

OBJECTIVE To investigate the antimicrobial resistance and microbial distribution of our hospital locafed in Xi'an in 2006-2008.METHODS Microbial sensitivity tests were determined by K-B disk diffusion method and data analyzed by WHONET5.4.RESULTS The top three clinical isolates of Gram-positive cocci were Staphylo- coccus aureus,Enterococcus faecalis and E.faecium during the three years.Linezolid,vancomycin and teicopla nin were the most active agents,the susceptibility to other commonly antibiotics was lower than 50.0%.The prevalence of MRSA during the three years was 60.0%,61.2%and 65.2%,respectively.The top three of Enterobacteriaceae bacteria were Eschorichia coli,Klebsiella pneumoniae and K.oxitoca.Imipenem was the most active agent against Enterobacteriaceae.The prevalence of ESBLs of E.coli and Klebsiella in three years were 49.1%,51.2%and 58.2%and 46.6%,60.0%and 67.9%,respectively.The top three nonfermenters were Pseudomonas aeruginosa ,Acinetobacter baumannii and Burkholderia cepacia.The most active agent was cefoperazone/sulbactam.The prevalence of multi-drug resistance(MDR)was 50.0%.CONCLUSIONS Vancomycin,teicoplanin and linezolid remain high activity against Gram-positive cocci.Carbapenams against Enterobacteriaceae remain high activity.There is an increasing trend of multi-resistant A.baumanni and P.aeruginosa.Increasing of MRS and ESBLs must bring a great concern.