2 527株临床分离病原菌的耐药性分析

目的 分析粤北人民医院临床分离病原菌对常用抗菌药的耐药性,为临床合理使用抗菌药物提供依据。方法 采用K-B法或MIC法对2013年2 527株临床分离株进行药敏试验。以CLSI 2012为判断标准,应用WHONET5.4和SPSS19.0软件进行数据分析,综合分析医院的耐药情况。结果 金黄色葡萄球菌中耐甲氧西林菌株占30.9%,耐甲氧西林凝固酶阴性葡萄球菌的检出率为76.2%,未检出万古霉素、利奈唑胺耐药菌株。屎肠球菌对所测抗菌药物的耐药性显著高于粪肠球菌,屎肠球菌中未检出糖肽类和利奈唑胺耐药菌株,但是粪肠球菌中检出1株利奈唑胺耐药菌株,检出2株替考拉宁耐药菌株。肠杆菌科细菌对碳青霉烯类抗生素仍高度敏感,大肠埃希菌、肺炎克雷伯菌中产ESBLs株分别为43.9%和37.5%,检出5株对多黏菌素B耐药的铜绿假单胞菌,多重耐药鲍曼不动杆菌占了63.7%。结论 临床病原菌耐药性较严重,应加强监测,临床应依据药敏结果合理的应用抗生素。

Drug Resistance Spectrum Analysis of 2 527 Clinical Isolates of Bacteria

Objective To investigate the resistance of clinical isolates from Yuebei People's Hospital so as to provide the reference forclinical use of antibiotics.Methods To comprehensively analyze the drug resistance,AST was performed with K-B or MIC method to 2 527 strains of clinical isolates and the data were analyzed by WHONET 5.4 and SPSS19.0 softwares according to the breakpoints of CLSI 2012 standard.Results MRSA accounted for 30.9% in Staphylococcus aureus isolates,MRCNS accounted for 76.2% incoagulase negative Staphylococcus isolates,no detection of vancomycin or linezolid resistant strains.The antimicrobial drugresistance of Enterococcus faecium was significantly higher than that of Enterococcus faecalis,no detection of glycopeptide and linezolid resistant strains in Enterococcus faecalis,but one linezolid resistant strains and twoteicoplanin resistant strains in Enterococcus faecalis.Enterobacteriaceae remain highly sensitive to carbapenem antibiotics,ESBLs produced strains in Escherichia coli,Klebsiella pneumoniae were 43.9% and 37.5% respectively,five polymyxin B resistant strains were detected in Pseudomonas aeruginosa,and 63.7% of MDRO rate in Acinetobacter baumannii.Conclusion Drug resistance of clinical pathogenic bacteria remain seriously in hospital,clinical application of antibiotics should be reasonable based on the result of drug sensitivity.