某院2012年临床常见病原菌耐药性及与Mohnarin报告对比分析

目的了解某院2012年1-12月临床分离的常见病原菌对不同类型抗菌药物的耐药情况，并与2012全国细菌耐药监测网Mohnarin报告作对比，为临床合理使用抗菌药物提供依据。方法对临床送检标本进行培养，检测病原菌的最低抑菌浓度（MIC），并与全国细菌耐药监测结果对比分析耐药率绝对差值，用χ2检验逐个对抗菌药物比较其总体差异性。结果4种常见革兰阴性菌（鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌）整体耐药率略高于2012年度全国细菌耐药率；金黄色葡萄球菌耐药率低于全国平均水平(P＜0.01)，其中耐甲氧西林金黄色葡萄球菌（MRSA）检出率为19.25％，低于全国平均水平（46.1%），未检出耐万古霉素菌株。大肠埃希菌、肺炎克雷伯菌中产超广谱β 内酰胺酶（ESBLs）检出率较高，分别为37.54％和21.33％，高于全国平均水平（分别为26.2%和16.2%）；多重耐药鲍曼不动杆菌和铜绿假单胞菌检出率分别为9.2%和1.5%，与全国水平相近。结论该院细菌耐药性较稳定。开展细菌耐药性监测，对指导临床合理用药及经验应用抗菌药物具有重要意义。

Antimicrobial resistance of common pathogenic bacteria in a hospital in 2012 and comparison with Mohnarin report

ObjectiveTo investigate antimicrobial resistance of commonly isolated pathogenic bacteria in a hospital between January and December 2012, and compared with report of Ministry of Health National Antimicrobial Resistance Investigation Net(Mohnarin),so as to provide reference for the rational use of antimicrobial agents．MethodsClinical specimens were cultured, minimal inhibitory concentration(MIC) of pathogenic bacteria were detected and compared with the absolute difference in drug resistance rate of Mohnarin report,the overall difference in antimicrobial resistance rates was compared respectively by χ2 test.ResultsIn 2012, the total resistance of four kinds of gram negative bacteria (Acinetobacter baumannii，Escherichia coli，Klebsiella pneumoniae, Pseudomonas aeruginosa) were slightly higher than Mohnarin report; resistance rate of Staphylococcus aureus was lower than average level of Mohnarin report (P<0.01),detection rate of methicillin resistant Staphylococcus aureus was 19.25%,which was lower than 46.1% of average level of Mohnarin report, vancomycin resistant bacterial strain was not found. Extended spectrum β lactamase producing Escherichia coli and Klebsiella pneumoniae was higher than average level of Mohnarin report respectively(37.54% vs 26.2%; 21.33% vs 16.2%,respectively); multidrug resistant Acinetobacter baumannii and Pseudomonas aeruginosa was 9.2% and 1.5% respectively, which approximating to the detection rate of average level of Mohnarin report.ConclusionAntimicrobial resistance of pathogenic bacteria is stable in this hospital, monitor on bacterial antimicrobial resistance is significant for the rational clinical use of antimicrobial agents.