上海地区细菌耐药性监测分析

目的 了解上海地区细菌耐药性流行趋势。方法 1999年1月1日至12月31日在上海市11家医院共分离14855株细菌，并排除同一患者的重复菌株，按统一方案用Kirby-Bauer法进行药敏试验，按美国临床实验标准委员会1999判断标准分析结果。结果 甲氧西 林耐药株分别占金黄色 葡萄球菌和凝固酶阴性葡萄球菌的64％和77％，未发现万古霉素耐药株。肠球菌中万古霉素耐药株分别占粪肠球菌和屎肠球菌的3.5％和1.7％。大肠杆菌对派拉西林、大毒素和氟喹诺酮类耐药株约占50％或以上。此外，克雷伯菌属、肠杆菌属、枸橼酸菌属和不动杆菌属对第三代头孢菌素的耐药率均有显著增高。铜绿假单胞菌对头孢他啶和亚胺培南的耐药率亦已分别增至27％和20％。结论 上海地区细菌耐药性呈上升趋势。制订一项限制和谨慎使用抗生素药物的全国性政策为当务之急。

Surveillance of bacterial resistance in Shanghai

Objective To analyze the surveillance data on bacterial resistance in Shanghai hospitals reported from January 1 to December 31, 1999. Methods Data on bacterial susceptibility testings of 14 855 clinical isolates collected from eleven Shanghai hospitals were performed using Kirby Bauer method and the results were analyzed according to NCCLS (1999). Results Methicillin resistant strains accounted for 64% and 77% of S. aureus and CNS respectively; and no vancomycin resistant strains were found. In Enterococcus spp , vancomycin resistant strains accounted for 3.5% and 1.7% of E.fecalis and E.fecium , respectively. Resistant rates of E.coli against piperacillin, gentamicin and fluoroquinolones were about 50% or higher. Resistant rates of Klebsiella spp, Enterobacter spp, Citrobacter spp and Acinetobacter spp against the third generation cephalosporins have increased markedly. Besides, the resistant rates of P.aeruginosa against ceftazidime and imipenem have increased to 27% and 20% respectively. Conclusion A national strategy on the restrictive and prudent use of antibiotics is urgently needed.