临床细菌耐药分析及耐药酶的检测

目的监测本地区2000-2006年临床细菌的构成分布及耐药性,并检测其是否产耐甲氧西林金黄色葡萄球菌(MRS)、耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)、超广谱β-内酰胺酶(ESBLs)。方法MicroSCANAUTOSCAN4半自动鉴定药敏仪对送检标本进行菌种鉴定和药敏试验,琼脂筛选法检测MRS、MRCNS,K-B纸片扩散法检测ESBLs,比较产酶株与非产酶株对抗菌药物的活性。结果8448份临床标本检出各种细菌2436株,检出率为28.84%,种类以革兰阴性杆菌为主,占45.26%,最常检出的细菌依次为大肠埃希菌、CNS(-)葡萄球菌、肺炎克雷伯菌、铜绿假单胞菌、肠球菌属、金黄色葡萄球菌,MRS、MRCNS、ESBLs检出率高,耐药性强,耐药谱广。结论临床分离菌以条件致病菌为主,耐药株分离高,建议临床医生根据药敏试验合理用药,以减少耐药菌株产生。

Analysis of Clinical Bacteria Drug Resistance and Detection of Drug Resistance Enzyme

Objective To monitor the local clinical bacteria distribution and their drug-resistance,and to detect MRS,MRCNS,and ESBLS in these clinical isolates.Methods Antimicrobial sensitivities were determined by Dade MicroSCAN AUTOSCAN4.MRS and MRCNS were detected with agar filtration method.ESBLs were detected with K-B susceptibility method.Results Among the 2,436(28.84%)strains of germs isolated from 8,448 clinical samples,Gram-negative bacilli were the dominant pathogens(45.26%).The pathogenic bacteria were Escherichia colia,and followed by Coagulase-negative staphylococous,Klelosiella pneumoniae,Pseudomonase aeruginosa,enterococcus and staphylococous.MRS,MRCNS,and ESBLs showed high positive testing rate,and also had strong and wide drug-resistance spectrum.Conclusions Conditional pathogens are the major clinical bacteria and the drug-resistance is higher,therefore the clinicians should choose the suitable antibiotics according to the results of antibiotic susceptibility test for reducing the drug-resistance strain.