北京地区部分医院细菌对常用抗生素耐药性现状及变迁

调查北京地区临床分离菌对抗生素耐药现状及变迁情况。方法将北京地区１２家医院抗生素对临床分离菌抑菌圈直径结果输入计算机，采用“ＷＨＯＮＥＴ”软件进行统计和分析，根据１９９４年发表的ＮＣＣＬＳ标准判断细菌耐药性。结果１９９５年共分离临床致病菌１０３０５株，耐药率如下：（１）大肠杆菌：阿米卡星８％、头孢他啶１５％、其它三代头孢菌素约３０％；（２）克雷佰菌属：氧氟沙星０％、头孢他啶７％、阿米卡星９％；（３）绿脓杆菌：阿米卡星１６％、头孢他啶１５％、环丙沙星１７％、诺氟沙星１５％、氧氟沙星５％；（４）金黄色葡萄球菌：去甲万古霉素０％；（５）肺炎链球菌：青霉素Ｇ９％；（６）肠球菌：去甲万古霉素７％。１９９０～１９９５年的连续６年监测中，发现大部分临床分离菌对以诺氟沙星为代表的喹诺酮类药物耐药率上升显著，但绿脓杆菌对除喹诺酮类以外药物的耐药率没有明显变化。结论在临床使用抗菌药物进行治疗时，应对抗菌药物耐药现象特别注意，及时掌握细菌对抗菌药物耐药的最新动态

Trends and changes in antimicrobial resistance of clinical isolates from 11 hospitals in Beijing area

Objective To study the antimicrobial resistance and its changes of clinical isolates in Beijing area.Methods The diameters of the inhibition zones of clinical isolates around antibiotic susceptibility test discs at 12 hospitals in Beijing area were computerfiled and analysed by the software of 'WHONET' according to NCCLS published in 1994.Results A total of 10305 isolates were collected in1995.The percentages of resistance were as follows:(1)in E.coli:amikacin,8%,ceftazidime,15%, the other third generation cephalosporins,about 30%,(2)in Klebsiella spp:ofloxacin,0%,ceftazidime,15%, ciprofloxacin,17%,norfloxacin,15%,ofloxacin,5%.(4)in Staph.aureus:norvancomycin,0%, (5)in Strep.pneumoniae:penicillin G,9%,(6)in Enterococcus spp:norvancomycin,7%.The antimicrobial resistant changes over a six year period from 1990 to 1995 were surveyed and it was found that resistant percentage of the most isolates to quinolones,for example norfloxacin,increased significantly year by year and no remarkable differences of resistance to antimicrobial agents but quinolones were observed in Ps.aeruginosa.Conclusion Antimicrobial resistance should be emphasised during clinical therapy with antimicrobial agents,and trends in antimicrobial resistance of isolates should be followed.