2009年十堰太和医院细菌耐药性监测

目的:了解太和医院2009年度临床分离菌对常用抗菌药物的耐药性。方法:临床分离菌采用K-B法进行抗菌药物药敏试验。按CLSI 2008版判断结果。结果:收集太和医院2009年1~12月临床分离株3 600株,其中革兰阳性球菌占59.08%,革兰阴性杆菌占40.92%。MRSA和MRCNS分别为40.72%,75.94%。大肠埃希菌、克雷伯菌属(肺炎克雷伯菌和产酸克雷伯菌)中产ESBLs株为76.78%和64.77%。甲氧西林耐药株对各抗生素的耐药率显著高于甲氧西林敏感株,未发现万古霉素耐药株。粪肠球菌对多数测试药物的耐药率低于屎肠球菌,二者均出现少数耐万古霉素菌株。未发现肺炎链球菌对青霉素不敏感株。肠杆菌科细菌中产ESBLs株对抗菌药物的耐药率均比非产ESBLs株高。肠杆菌科细菌对碳青霉烯类抗生素仍高度敏感。铜绿假单胞菌对亚胺培南、美罗培南耐药率分别为25.0%、22.5%;不动杆菌属对二者的耐药率分别为76.6%、67.8%。结论:细菌耐药性仍呈增长趋势,应及早采取防控措施。

Surveillance of Bacterial Resistance in Shiyan Taihe Hospital in 2009

Objective To investigate the resistance of clinical isolated strains from Taihe hospital in 2009.Methods The bacterial susceptibility testing was carried out with Kirby-Bauer method and the results were analyzed according to CLSI 2008.Results From January to December 2009,3 699 strains were isolated from clinical.The proportions of gram positive bacteria and gram negative bacteria in all strains were 40.92%and 59.08%,respectively.The rates of meticillin resistant staphylococcus aureus（MRSA） and coagulase negative staphylococcus（MRCNS）were 40.72%and 75.94%,respectively.Extended-spectrum beta-lactamases（ESBLs）strains in E.coli and Klebsiella spp accounted for 76.78% and 64.77% respectively.The resistance rates of MR strains to antimicrobial agents were significantly higher than those of meticillin-sensitive strains,and no vancomycin resistant strain was found.The resistance rates of E.faecalis strains to most tested drugs were lower than those of E.faecium,no penicillin non-susceptible strains in S.pneumoniae was found.The resistance rates of ESBLs positive strains were higher than those of ESBLs negative strains to most tested drugs.Strains of Enterobacteriaceae were still highly susceptible to imipenem and meropenem.The resistance rates of P.aeruginosa strains to imipenem and meropenem were 25.0% and 22.5%,respectively.The resistance rates of Acinetobacter spp to the above two drugs were 76.6% and 67.8%,respectively.Conclusion Bacterial resistance showed an increasing tendency and it is neccssary for hospitals to take effective control measures.