2012年成都市第三人民医院细菌耐药性监测数据分析

目的了解2012年度医院临床分离病原菌的分布和耐药情况，为指导合理用药，控制医院感染提供参考依据。方法采用德灵Microscan96全自动生化鉴定系统对临床分离细菌进行药物敏感试验，依据CLSI2012年标准，采用WHONET5．6软件对数据进行统计分析。结果共分离出病原菌株5854株，前10位病原菌依次为大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌、金黄色葡萄球菌、阴沟肠杆菌、肺炎链球菌、副流感嗜血杆菌、嗜麦芽窄食单胞菌、屎肠球菌。未检测到对万古霉素耐药的葡萄球菌；屎肠球菌对万古霉素耐药率为5．8％；大肠埃希菌、肺炎克雷伯菌产超广谱B内酰胺酶检出率分别为47．7％和33．8％；铜绿假单胞菌和鲍氏不动杆菌对亚胺培南耐药率分别为30．0％和37．5％。结论病原菌耐药形势严峻，应定期进行细菌耐药监测，及时掌握细菌耐药性变化，为指导临床合理使用抗生素提供依据。

Bacterial Drug Resistance Surveillance in the Third People Hospital of Chengdu of 2012

Objective To understand the distribution and drug resistance of clinical isolates of pathogens, and to provide a reference guide for rational drug use to control hospital infection. Methods Bacterial isolates were cultured by routine methods and identified by the MicroScan Walkaway 96 Automated Microbial System. Drug susceptibility test was according to CLSI standards. Data statistic and analysis used WHONET 5.6 software. Results 5 854 strains were isolated, the top ten pathogens were E. Coli, K. Pneumonia,A. Baumannii, P. aeruginosa, S. aureus, E. Cloacae, S. pneumoniae, H. Parainfluenzae, S, maltophilia and E. faecium. No linezolid-resistant Staphylococcus strains was found. The drug resistance rates of E. faecium towards vancomycin were 5. 8%. The rates of extended-spectrum β-lactamases（ESBLs） producing E. coli and K. pneumoniae were 47.7% and 33.8%. The drug resistance rates of P. aeruginosa and A. Baumannii towards imipenem were 30. 0%0 and 37. 5%. Conclusion Resistant pathogens situation is terrible. Antimicrobial resistance monitoring should be conducted regularly to grasp the changes in bacterial resistance,and to provide the basis for guiding rational use of antibiotics.