2008至2010年3年细菌的耐药监测研究

目的分析2008至2010年本院3年临床分离菌的耐药情况。方法用纸片扩散法进行抗菌药物敏感实验,根据CLSI标准用WHONET 5.4软件进行数据分析。结果 3年临床分离的4916株病原菌中,革兰阳性菌占22.7%,革兰阴性菌占77.3%;3年耐甲氧西林金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)总检出率分别为59.3%,89.5%。大肠埃希菌、肺炎克雷伯菌超广谱β内酰胺酶(ESBLs)总检出率分别为57.5%,34.6%。鲍曼不动杆菌对碳青霉烯类抗菌药物的耐药率有逐年上升趋势,而铜绿假单孢菌则有下降趋势。结论革兰阳性菌对万古霉素、替考拉宁、利奈唑胺均敏感;肠杆菌科细菌对碳青霉烯类药物耐药率较低,但产ESBLs肠杆科细菌较不产ESBLs肠杆科细菌耐药严重;鲍曼不动杆菌对常见抗菌药物的耐药率高,且明显高于铜绿假单孢菌。

Surveillance of antimicrobial resistance in clinical isolates in our hospital from 2008 to 2010

Objective To analyze the tendency and antimicrobial resistance of clinical isolates in our hospital from 2008 to 2010.Methods Disk diffusion method was used to determine the antimicrobial susceptibility.And the WHONET 5.4 software was used to analyze the data based on the annual CLSI.Results Of 4916 clinical isolates,gram-positive organisms accounted for 22.7%,and gram-negative organisms 77.3%.The detection rates of methicillin-resistant Staphylococcus aureus(MRSA) and coagulase-negative staphylococci(MRCNS) were 59.3% and 89.5%,respectively.Total extended-spectrum β lactamases(ESBLs)-producing Escherichia coli and Klebsiella spp were accounted for 57.5% and 34.6%,respectively.The carbapenem resistance rate in Acinetobacter Spp has increased year by year.There was a decreased tendency for the carbapenem resistance rate in Pseudomonas aeruginosa.Conclusion Gram-positive bacteria are still susceptible to the vancomycin teicoplanin and linezolid.Enterbacteriaceae bacteria are still very sensitive to carbapenems.But,the ESBLs-producing strains in Enterobacteriaceae are more resistant than none strains.Acinetobacter baumannii are more drug resistant,comparing to Pseudomonas aeruginosa.