Antibiotic resistance of commensal Escherichia coli of food-producing animals from three Vojvodinian farms, Serbia

Commensal bacteria of food-producing animals are considered an important reservoir of antibiotic resistance. The aim of this study was to determine the current prevalence of resistance to 18 different antibiotics in animal commensal Escherichia coli isolated from food-producing animals from three different farms with specific modes of antimicrobial use. A very high prevalence of resistance was found to tetracycline, a moderate level to streptomycin, ampicillin, cefalothin and nalidixic acid and a low of resistance to the other tested antibiotics. Resistance to two or more antibiotics was observed among all swine E. coli, 63.2% of broiler isolates and 37.5% of cattle isolates. The results show that commensals of food-producing animals from Vojvodina region are important reservoirs of resistance to older-generation antibiotics.     

Prevalence and determinants of antibiotic resistance in faecal Escherichia coli among unselected patients attending general practitioners in Southwest Germany

PURPOSE: Widespread use of antibiotics is thought to be the main reason for the world-wide increase in antibiotic resistance. Although a great majority of antibiotics are prescribed outside hospitals, little is known about the prevalence and determinants of antibiotic resistance in the general population. METHODS: Escherichia coli (E. coli) was cultured from and minimal inhibitory concentrations against six commonly prescribed antibiotic substances were tested in 750 stool samples of 484 unselected, consecutive outpatients aged 40-74 years attending general practitioners. Odds ratios (OR) and their 95% confidence intervals (CI) for the association between potential risk factors and the prevalence of antibiotic resistance were estimated using generalised estimating equations. RESULTS: Prevalence of E. coli resistance against ampicillin, doxycycline, cotrimoxazole or quinolones was 24%. Current antibiotic use was strongly associated with antibiotic resistance, adjusted OR: 11.1, 95% CI: 2.3-53, but antibiotic resistance was unaffected by antibiotic use stopped weeks before. Recent hospitalisations were the only other significant predictor of an increased prevalence of resistance. CONCLUSIONS: The strong association between current use of antibiotics and colonisation with antibiotic resistant E. coli suggests a major role for selection of resistant strains while using antibiotics that seem to be quickly reversible, though.     

Antibiotic sensitivity of enteric pathogens in Vietnam

The in vitro antimicrobial susceptibilities of 675 common enteropathogenic isolates from faecal specimens of patients with diarrhea (E. coli, Shigella, Salmonella and V. cholerae), and 568 E. coli isolates from faecal flora of healthy persons, which were collected as part of a National antibiotic resistance surveillance in Vietnam, were determined. The agar dilution method was used for the following nine antibiotics: ampicillin, doxycycline, chloramphenicol, gentamicin, nalidixic acid, kanamycin, trimethoprim, trimethoprim in combination with sulfamethoxazole (1/20), and sulfisomidin. Gentamicin was the most active of the antibiotics tested against all bacterial species with MICs in the range 0.125-4 mg/l. All strains were susceptible to nalidixic acid (0.125-8 mg/l) and more than 90% were susceptible to kanamycin. Among E. coli and Shigella isolates from patients the frequencies of resistance to commonly used antibiotics were high: ampicillin 73% and 84%, doxycycline 83% and 94%, chloramphenicol 71% and 91%, sulfisomidin 82% and 92%, respectively. Resistance to trimethoprin, as well as to the combination with sulfamethoxazole was found in 21% and 23%, respectively. The frequencies of multiple resistance (resistance to three or more antibiotics) were also high (77% and 89%, respectively). Less than 10% of Salmonellae and V. cholerae isolates were resistant to ampicillin, sulfisomidin or trimethoprim. Among E. coli from healthy people the frequencies of resistance were lower than in isolates from patients: ampicillin 23%, doxycycline 40%, chloramphenicol 21% and sulfisomidin 34%. However, the same patterns of multiple resistance were found in both groups.     

Antimicrobial resistance in Escherichia coli and Pseudomonas aeruginosa from Intensive Care Units in The Netherlands, 1998-2005

In 1998, a nationwide surveillance of antibiotic resistance among Escherichia coli and Pseudomonas aeruginosa isolates of patients from 14 Intensive Care Units in The Netherlands was initiated. Minimal inhibitory concentrations (MICs) of broad-spectrum penicillins with and without beta-lactamase inhibitors, cephalosporins, aminoglycosides and fluoroquinolones were determined by a broth microdilution method. An increase in percentages of resistance of E. coli and P. aeruginosa to most antibiotics tested was observed, but rates were still lower than those described in other countries. For E. coli, resistance to amoxicillin was fairly stable at 44% until 2004 and increased to 56% (P=0.01) in 2005. Similarly, piperacillin had a resistance rate of ca. 11% until 2004, which then increased to 38% in 2005 (P<0.001). The MIC distributions of piperacillin and piperacillin/tazobactam for P. aeruginosa were almost identical, as were the resistance rates (4-14%). Resistance to ciprofloxacin nearly doubled in 2005 compared with previous years. Changes in resistance to the antibiotics tested were confirmed by trend analysis. Together with infection control measures, antibiotic resistance surveillance is an important tool to control the antibiotic resistance problem.     

Antibiotic resistance in a very remote Amazonas community

In a very remote human community of the Peruvian Amazonas with minimal antibiotic exposure, high levels of acquired resistance to the oldest antibiotics (ampicillin, tetracycline, trimethoprim/sulfamethoxazole, streptomycin and chloramphenicol) were detected in commensal Escherichia coli, with remarkable diversity of resistant clones and of resistance genes and plasmids. This pattern was similar overall to that previously observed in a very remote community of Bolivia. It was also similar to that observed in the nearest urban area, except for a lower dominance of resistant isolates and the absolute lack of quinolone resistance in the remote community. Present findings suggest that antibiotic resistance observed in remote communities with minimal antibiotic exposure is a general phenomenon contributed by complex mechanisms and provide new insights into the mechanisms involved in this phenomenon.     

儿童常见病原菌的分布及其耐药性监测

目的?调查我院临床分离病原菌菌群分布并进行耐药性监测,为临床合理使用抗生素提供依据。方法:我院 2001 年 1 月至2002 年 12 月临床分离病原菌 4328 株,按 NCCLS( 2000)标准判断结果, 2853 株 G 杆菌和 G 球菌采用 M icroScan鄄W alkAway40 全 - +自动微生物分析仪鉴定及药敏, 1478 株苛氧菌采用 Kirby鄄Bauer法进行纸片药敏实验。结果: 2583 株 G 杆菌和 G 球菌中,杆菌占 - +74.6% ,其中以大肠埃希氏、肺炎克雷伯菌为主;球菌占 25.4% ,其中以金黄色葡萄球菌和表皮葡萄球菌为主;呼吸道苛氧菌以肺炎链球菌和副流感嗜血杆菌为主,分别是 31.4% 、 35.2% 。药敏结果显示:大肠埃希氏、肺炎克雷伯菌除对亚胺培南、哌拉西林鄄 他唑巴坦、头孢西丁、阿米卡星敏感,而对其它抗生素的耐药率均 > 50% 。铜绿假单孢菌、阴沟杆菌对环丙沙星、亚胺培南敏感,而对其它药物均有不同程度耐药。嗜麦芽黄单孢菌呈高度多重耐药性。金黄色葡萄球菌对氨苄西林、青霉素、红霉素耐药率分别高达 97% 、97% 、 ,其它 G+ 球菌对大多数抗生素的耐药率为 60% ￣90% ;呼吸道苛     

2020年蚌埠医学院第一附属医院细菌耐药性监测

摘要：目的 通过对2020年蚌埠医学院第一附属医院临床分离菌分布及对抗菌药物的耐药性分析,为临床合理选择抗菌药物提供参考。方法 采用自动化仪器法、纸片扩散法(K-B法)或E-test方法对我院2020年临床分离的菌株进行药敏试验,按CLSI 2020版标准判断结果,WHONET5.6软件统计分析数据。结果 2020年我院临床共分离4209株细菌,其中革兰阳性菌1121株(26.6%,1121/4209),革兰阴性菌3088株(73.4%,3088/4209)株,前10位分离菌分别为：大肠埃希菌1093株(26.0%)、肺炎克雷伯菌565株(13.4%)、凝固酶阴性葡萄球菌402株(9.6%)、鲍曼不动杆菌354株(8.4%)、铜绿假单胞菌345株(8.2%)、金黄色葡萄球菌313株(7.4%)、奇异变形杆菌132株(3.1%)、屎肠球菌122株(2.9%)、粪肠球菌94株(2.2%)和阴沟肠杆菌63株(1.5%)。金黄色葡萄球菌和凝固酶阴性葡萄球菌中耐甲氧西林菌株的检出率分别为43.1%和66.2%,未检出耐万古霉素和利奈唑胺菌株。肠球菌属细菌中以屎肠球菌和粪肠球菌为主,屎肠球菌对大多数测试抗菌药物的耐药率高于粪肠球菌,检出少数耐万古霉素和利奈唑胺药的肠球菌。大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)菌株占各自菌的63.1%和31.2%,肺炎克雷伯菌亚胺培南和厄他培南耐药率分别为26.7%和26.4%,较我院2017年有所下降(P<0.01),其余肠杆菌目细菌对碳青霉烯类抗生素耐药率均小于10%。铜绿假单胞菌对亚胺培南耐药率为34.2%,对头孢吡肟、哌拉西林/他唑巴坦、氨曲南、左氧氟沙星和阿米卡星的耐药率均小于30%。鲍曼不动杆菌对阿米卡星的耐药率为31.0%,亚胺培南耐药率为89.5%。流感嗜血杆菌产β-内酰酶检出率为60.7%。结论 临床分离菌对常见抗菌药物耐药情况较严重,耐碳青霉烯类肺炎克雷伯菌的检出率有所下降,但仍值得警惕,应重视细菌耐药监测,继续加强医院感染的防控,合理使用抗菌药物。     

美洛培南对临床分离菌耐药性测定

目的 :探讨美洛培南对临床分离菌的耐药性。方法 :选取150株临床分离菌应用K -B法测定美洛培南等抗生素的耐药性 ,同时比较了美洛培南及亚胺培南对大肠埃希氏菌的耐药谱。结果 :美洛培南对临床分离菌敏感率为100 % ,美洛培南与亚胺培南对大肠埃希氏菌无交叉耐药。结论 :美洛培南对临床分离菌有高度敏感性 ,其抗菌谱与亚胺培南相似     

Antibiotic resistant fecal isolates of Enterococci among unselected patients outside the clinical sector: an epidemiological study from Southern Germany

PURPOSE: The aim of the study was to assess the prevalence and determinants of antibiotic-resistant Enterococci in a large group of outpatients in Southern Germany. METHODS: Stool samples were collected from 497 unselected patients aged 40-75 years attending general practitioners. Enterococcus faecium (E. faecium) and Enterococcus faecalis (E. faecalis) were cultured and minimal inhibitory concentrations of antibiotics used inside and outside the clinical sector were tested. RESULTS: E. faecium and E. faecalis could be identified and cultured in 60 (12.4%) and 205 (41.2%) of the stool samples, respectively. Under non-selective culture conditions no vancomycin-resistant Enterococcus (VRE) isolate was found. Only E. faecium isolates showed resistance to fluoroquinolones, 40% were resistant to ciprofloxacin. The prevalences of E. faecium resistance to ampicillin and doxycycline were 3.3% and 13.3%, respectively, whereas 0.5% and 29.6% of the E. faecalis isolates were resistant to ampicillin and doxycycline, respectively. Antibiotic use during the last 3 months was significantly associated with antibiotic resistance (to either ampicillin, imipenem, or doxycycline) of E. faecalis isolates (OR: 2.9; CI: 1.2-6.8). CONCLUSIONS: Prevalences of resistance were generally lower than and patterns of resistance were quite different from previous investigations in the clinical setting. Recent antibiotic use was associated with increased colonization with resistant strains.     

肠杆菌科细菌3年耐药性监测

目的了解我院2008年—2010年间临床常见肠杆菌科细菌的耐药情况及研究耐碳青霉烯类大肠埃希菌碳青霉烯酶基因型,为临床合理使用抗菌药物提供依据。方法收集我院2008-2010年间临床分离的常见肠杆菌科细菌,药敏试验使用纸片扩散法,数据分析采用WHONET5.4软件;筛选出对碳青霉烯类耐药的大肠埃希菌进行碳青霉烯酶基因的PCR检测及基因序列分析。结果 3年分离病原株共4916株,肠杆菌科共1980株,其中列前三位的是大肠埃希菌(873/1980),克雷伯菌属(605/1980)及肠杆菌属(268/1980),其次为变形菌属和沙雷菌属。主要来源于痰液、尿液及分泌物、血液、脓液等。重要肠杆菌科细菌对碳青霉烯类耐药率均小于10%,对头孢哌酮/舒巴坦、阿米卡星、哌拉西林/三唑巴坦者<30%,对广谱青霉素类及头孢菌素类者为40.9%～98.7%。变形菌属除对氨苄西林的耐药率>75%外,对其余抗生素的耐药率均低于40%,。3年来产超广谱β-内酰胺酶大肠埃希菌为33.97%及肺炎克雷伯菌57.50%,对大多数抗生素的耐药率显著高于非ELSBs菌株,且呈多重耐药。3年耐碳青霉烯类的大肠埃希菌共23株,其中产碳青霉烯酶者2株,PCR检测基因型阴性。结论本院肠杆菌科细菌大肠埃希菌和肺炎克雷伯菌检出率较高,碳青霉烯类对肠杆菌科细菌的抗菌活性最高,产ESBLs肠杆菌的耐药严重,实验室应加强对产ESBLs细菌的监测与报告。未检测出我院大肠埃希菌碳青霉烯酶基因型。治疗肠杆菌科细菌感染可选择碳青霉烯类,哌拉西林/三唑巴坦,头孢哌酮/舒巴坦,阿米卡星。     

2018年内蒙古包头市细菌耐药性监测

目的 了解2018年内蒙古包头市11所参加全国细菌耐药监测网医院临床分离株的构成及耐药情况,为本地区临床合理化用药提供理论依据。方法 各成员医院按监测方案,采用纸片扩散法或自动化仪器检测法进行药敏试验,按美国临床实验室标准化研究协会(CLSI) 2017年版标准判读药敏结果,采用WHONET 5.6软件进行数据分析。结果 共收集上述医院非重复临床分离菌7773株,其中革兰阳性菌2138株,占27.5%,革兰阴性菌5635株,占72.5%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的平均检出率分别为12.2%和66.9%,MRSA和MRCNS对大多数抗菌药物的耐药率均显著高于甲氧西林敏感株(MSSA和MSCNS),未发现利奈唑胺、万古霉素和替考拉宁耐药菌株。屎肠球菌对大多数抗菌药物的耐药率均显著高于粪肠球菌,粪肠球菌中发现有3株利奈唑胺、1株万古霉素和1株替考拉宁耐药菌株。非脑脊液标本分离的肺炎链球菌对青霉素的耐药率为2.0%。大肠埃希菌和克雷伯菌属中产ESBL菌株的平均检出率分别为48.3%和20.6%,产ESBL菌株对所测抗菌药物的耐药率均高于非产ESBL菌株。肠杆菌科细菌中CRE的检出率为1.2%,CRKP菌株对阿米卡星的耐药率为64.3%。铜绿假单胞菌对碳青霉烯类、氨基糖苷类、喹诺酮类、头孢他啶、头孢吡肟、头孢哌酮/舒巴坦和哌拉西林/三唑巴坦的耐药率均低于15.0%。不动杆菌属对包括碳青霉烯类在内的大多数抗菌药物的耐药率超过38.0%,其中亚胺培南和美罗培南的耐药率分别为42.3%和43.5%。结论 我市细菌耐药情况较全国水平低,但仍呈缓慢增长趋势,应继续做好细菌耐药性监测工作,加强抗菌药物临床应用管理措施,以合理化使用抗菌药物。     

Occurrence of the Van Genes inEnterococcus faecalis andEnterococcus faecium from clinical isolates in Korea

Enterococcus faecalis and Enterococcus faecium isolated from Korea patients in 1998 and 2005 were tested for susceptibility to nine different antimicrobial agents, including vancomycin and teicoplanin. Polymerase chain reaction (PCR) was used for the detection of several vancomycin resistance genes such as vanA ('high level'), vanB ('moderate high level'), vanC1 and vanC2 ('low level'). Both E. faecalis and E. faecium exhibited a resistance of 80% and more than 60% to synercid and mupirocin, respectively. Moreover, an average of 76% of all isolates was resistant to ciprofloxacin, gentamicin, lincomycin, cefotaxime, and meropenem, confirming the multiple drug resistance of most of the isolates. No resistance to vancomycin or teicoplanin was observed in the 1998 E. faecalis and E. faecium isolates. However, the 2005 E. faecalis and E. faecium isolates exhibited resistance of 16% and 12% to vancomycin and teicoplanin, respectively. In addition, vanA gene was detected in 4 strains of 2005 E. faecium isolates, thus showing a high resistance to vancomycin. No other vancomycin resistance genes, including vanB, vanC1, and vanC2, were found in our isolates. In this study, we compared the occurrence of antimicrobial resistance and the presence of specific resistance genes in E. faecalis and E. faecium. The results showed that the 2005 isolates were usually more resistant than the 1998 isolates.     

Emerging resistance in Salmonella enterica serotype Typhi in Hong Kong

A total of 182 Salmonella enterica serotype Typhi isolated from three hospitals in Hong Kong from 1986 to 1992 were tested for their susceptibility to 21 antimicrobial agents. Four percent or less were resistant to chloramphenicol, ampicillin, some of the cephalosporins, nalidixic acid, tetracycline and trimethoprim and 6% to 1024 mg/l sulfamethoxazole. All were susceptible to the aminoglycosides and the 4-quinolones. Nineteen isolates were resistant to at least 1, and up to 9, antibiotics. Of 8 chloramphenicolor multiply-resistant isolates studied, only 3 could transfer their resistances while resistance of one could only be mobilized. Four of 5 ampicillin-resistant strains produced a beta-lactamase of pI 5.5. Antibiotic resistances were mediated by plasmids of 106, 116 or 221 kb of incompatibility groups H, I1 and K. Three resistant isolates did not harbour any plasmid. A total of 43 (24%) S. Typhi harboured plasmids ranging in size from 4.3 to 221 kb. Plasmids of 106 kb and 8.5 kb were found in 17 and 10 isolates, respectively. Restriction enzyme digestion of these two plasmids showed that each could be differentiated into 3 types. Of 89 isolates that were phage typed, 38% were untypable, while 17% and 12% were of phage types E1 and A, respectively, and the rest belonged to 17 other types.     

我院2009-2011年大肠埃希菌感染的耐药性分析

目的了解我院2009-2011年大肠埃希菌的分离情况及耐药性变化趋势,指导临床合理使用抗菌药物。方法收集2009-2011年临床分离的大肠埃希菌1 045株,对其药敏结果进行统计、分析。结果 1 045株大肠埃希菌对常用抗菌药物均产生不同的耐药性,对氨苄西林、复方新诺明、头孢唑林、头孢呋辛、哌拉西林、氨苄西林/舒巴坦耐药率较高,3年平均耐药率均>50%;对碳青霉烯类抗菌药物亚胺培南敏感率为100%;产超广谱β-内酰胺酶大肠埃希菌的检出率分别为5.3%、5.2%、12.8%。结论大肠埃希菌耐药性基本稳定,临床医师应根据药敏试验结果有针对性地合理选用抗菌药物,以提高疗效,并减少耐药菌株产生。     

Antibiotic resistance in Escherichia coli isolates obtained from animals, foods and humans in Spain.

Antibiotic resistance was investigated in 474 Escherichia coli isolates recovered from animal faeces (broilers, pigs, pets, bulls and horses), human faeces (patients and healthy volunteers) and food products of animal origin. E. coli isolates (3260) recovered from human significant infectious samples were also included. There was a high frequency of nalidixic acid, ciprofloxacin and gentamicin resistance in E. coli isolates from broilers (88, 38 and 40%, respectively), and from foods (53, 13 and 17%). High levels of resistance to trimethoprim-sulphamethoxazole and tetracycline have been found in E. coli isolates from broilers, pigs and foods. These data raise important questions about the potential impact of antibiotic use in animals and the possible entry of resistant pathogens into the food chain.     

动物及健康人肠道共生的大肠埃希菌耐药性及产生原因分析

目的了解目前动物和人肠道共生的大肠埃希菌耐药性,分析其产生的原因。方法从甘肃、湖北、北京、山东、四川等地相对封闭的养殖场及养殖场附近的健康人群采集鸡、猪、鱼、人粪便样本,分离大肠埃希菌。用AP I20E鉴定条鉴定怀疑为大肠埃希菌的菌种,采用KB纸片法检测生化鉴定为大肠埃希菌的菌株的耐药性,利用WHONET 5.3软件进行药敏试验数据分析。用脉冲场凝胶电泳技术检测具有相似耐药谱型的大肠埃希菌菌株间的同源性。结果①共收集571株大肠埃希菌,其中从海水养殖鱼类和淡水养殖鱼类分离31株,另从海水养殖鱼类和淡水养殖鱼类分离嗜水气单胞菌株57株;②来源鸡的大肠埃希菌对所有检测的抗菌药物的耐药率最高;③除β-内酰胺类抗生素和阿米卡星外,鸡、猪和人来源菌株的耐药率表现为高、中、低现象,对老的一些抗菌药物和喹诺酮类抗菌药物尤其明显;不同地区分离株的耐药性也有较大的差异;④本次调查首次在国内养鸡场发现产ESBL大肠埃希菌,并且非常多见;⑤嗜水气单胞菌和大肠埃希菌的耐药性有较大的差异,47株耐药谱型相近的菌株中发现了三组基因水平同源性菌株(相似度大于95%)。结论①从不同地区、不同种类动物分离菌株的耐药性不同,与抗生素的使用情况相关。目前我国家禽养殖业滥用喹诺酮类和β-内酰胺类尤其是三代头孢菌素类抗生素的现象较为普遍,应该加以严格控制;②不同菌种的生物学特性不同,导致耐药性不同;③同源性分析发现耐药菌株可在同一种类动物间传播,不同类动物的大肠埃希菌之间可能存在耐药基因的水平传播;④应当加强养殖动物分离的大肠埃希菌耐药性监测。     

NICU感染ESBLs大肠埃希菌与肺炎克雷伯菌的耐药性分析

目的了解NICU感染产超广谱β-内酰胺酶(ESBLs)大肠埃希菌与肺炎克雷伯菌耐药发生情况,以更好的选择抗菌药物提供依据。方法细菌鉴定和药敏试验用ATB Expression细菌鉴定仪及其配套试剂进行自动分析。结果 2010～2012年全院共培养和分离出大肠埃希菌3043株与肺炎克雷伯菌2226株。NICU大肠埃希菌374株(12.29%)中产ESBLs145株(38.77%)和肺炎克雷伯菌799株(34.41%)产ESBLs 384株(48.06%)。产ESBLs菌对青霉素类、头孢菌素和氨曲南均产生耐药,第四代头孢头孢吡肟耐药率也达60%以上,对亚胺培南或美洛培南、丁胺卡那耐药低,其次为派拉西林/他唑巴坦和头孢西丁。而头孢西丁在产ESBLs肺炎克雷伯菌耐药率已上升至50%。结论新生儿为一特殊群体在临床用药相对较为狭窄,在实验室开展ESBLs的检测,对指导临床合理使用抗菌药物、延缓细菌耐药性的产生、有效控制产ESBLs菌的院内播散具有十分重要的意义。     

2016—2018年河南省儿童医院细菌分布及耐药性分析

目的 了解河南省儿童医院2016—2018年临床分离菌株的分布及常用抗菌药物的耐药情况,为儿科临床合理用药提供依据。方法 选择2016—2018年所有临床分离菌株,采用Phoenix 100微生物分析仪和纸片扩散法进行药敏实验,按照历年CLSI标准判读药敏结果,用WHONET5.6软件进行耐药性分析。 结果 2016—2018年共收集临床非重复分离株21404株,其中革兰阳性菌7772株,占36.3%,革兰阴性菌13632株,占63.7%。无菌体液标本共分离出致病菌2312株,排在前三位的细菌为凝固酶阴性葡萄球菌、大肠埃希菌和肺炎克雷伯菌。 3105株非脑脊液分离的肺炎链球菌中青霉素不敏感率为0.5%。耐甲氧西林金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)平均检出率分别为34.2%和72.0%;MRSA和MRCNS对绝大多数测试抗菌药物的耐药率均显著高于甲氧西林敏感株金黄色葡萄球菌(MSSA)和凝固酶阴性葡萄球菌(MSCNS)。对万古霉素和利奈唑胺不敏感的葡萄球菌未检出。检出耐万古霉素屎肠球菌1株,未发现对万古霉素不敏感的粪肠球菌。流感嗜血菌β-内酰胺酶阳性率为53.7%,除了对复方磺胺甲噁唑的耐药率高于80.0%外,对大多数抗菌药物比较敏感。 2016—2018年大肠埃希菌产超广谱β-内酰胺酶(ESBL)的检出率依次为70.4%、72.1%和66.6%,大肠埃希菌对碳青霉烯仍高度敏感,3年来其对碳青霉烯类药物的耐药率都低于10.0%。2016—2018年肺炎克雷伯菌产ESBL检出率依次为61.3%、75.6%和72.0%,对亚胺培南的耐药率为39.3%、32.7%和43.1%,对美罗培南的历年耐药率为40.4%、30.8%和43.2%。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为22.8%和19.6%。鲍曼不动杆菌对美罗培南和亚胺培南的耐药率均为60.5%。结论 多重耐药细菌在儿童中的形势严峻,威胁着儿科临床的抗感染治疗,应加强耐药监测和采取行之有效的感染控制措施。     

2016—2018年河南省儿童医院细菌分布及耐药性分析

目的 了解河南省儿童医院2016—2018年临床分离菌株的分布及常用抗菌药物的耐药情况,为儿科临床合理用药提供依据。方法 选择2016—2018年所有临床分离菌株,采用Phoenix 100微生物分析仪和纸片扩散法进行药敏实验,按照历年CLSI标准判读药敏结果,用WHONET5.6软件进行耐药性分析。 结果 2016—2018年共收集临床非重复分离株21404株,其中革兰阳性菌7772株,占36.3%,革兰阴性菌13632株,占63.7%。无菌体液标本共分离出致病菌2312株,排在前三位的细菌为凝固酶阴性葡萄球菌、大肠埃希菌和肺炎克雷伯菌。 3105株非脑脊液分离的肺炎链球菌中青霉素不敏感率为0.5%。耐甲氧西林金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)平均检出率分别为34.2%和72.0%;MRSA和MRCNS对绝大多数测试抗菌药物的耐药率均显著高于甲氧西林敏感株金黄色葡萄球菌(MSSA)和凝固酶阴性葡萄球菌(MSCNS)。对万古霉素和利奈唑胺不敏感的葡萄球菌未检出。检出耐万古霉素屎肠球菌1株,未发现对万古霉素不敏感的粪肠球菌。流感嗜血菌β-内酰胺酶阳性率为53.7%,除了对复方磺胺甲噁唑的耐药率高于80.0%外,对大多数抗菌药物比较敏感。 2016—2018年大肠埃希菌产超广谱β-内酰胺酶(ESBL)的检出率依次为70.4%、72.1%和66.6%,大肠埃希菌对碳青霉烯仍高度敏感,3年来其对碳青霉烯类药物的耐药率都低于10.0%。2016—2018年肺炎克雷伯菌产ESBL检出率依次为61.3%、75.6%和72.0%,对亚胺培南的耐药率为39.3%、32.7%和43.1%,对美罗培南的历年耐药率为40.4%、30.8%和43.2%。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为22.8%和19.6%。鲍曼不动杆菌对美罗培南和亚胺培南的耐药率均为60.5%。结论     

第4代头孢菌素头孢吡肟的耐药性及耐药危险因素

目的：探索第4代头孢菌素头孢吡肟耐药危险因素,为临床合理治疗及应用抗菌药物提供依据。方法：以唐山市中医医院细菌室做细菌培养及药敏实验的765例患者共984株耐药菌为本次研究对象,对患者病历做回顾性调查,用SPSS 10.0进行统计学分析,χ2检验用于比较各组间率的差异。结果：共培养分离出耐药菌984株,以革兰阴性杆菌为主,占64.7%,头孢吡肟总耐药率为48.77%,除对嗜麦芽假单胞菌、肠球菌天然耐药外,对其他细菌耐药率在25%～65%之间,结论：不同细菌对头孢吡肟的耐药率不尽相同,但近年来其耐药率有上升趋势。耐药危险因素是混合感染、抗菌药物使用时间≥4周。