某院2004-2005年临床分离细菌耐药性研究

目的 调查某院2004年1月-2005年12月间常见病原菌的分布及其耐药性。方法 常规分离、培养并鉴定细菌，采用纸片扩散（K-B）法对细菌进行药物敏感试验。结果 在2220株细菌中，革兰阴性菌1310株（59．01％），革兰阳性菌910株（40．99％）。在大肠埃希菌和肺炎克雷伯菌中，超广谱β-内酰胺酶（ESBLs）的检出率分别为39．03％和38．33％。对于肠杆菌科细菌，亚胺培南和美罗培南的抗菌活性最强。非发酵菌中，铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为27．86％和29．66％；嗜麦芽窄食单胞菌对头孢哌酮／舒巴坦、复方磺胺甲嗯唑较敏感，耐药率分别为45．15％与17．74％。60．48％金黄色葡萄球菌和44．21％凝固酶阴性葡萄球菌为甲氧西林耐药株，但均对万古霉素敏感。粪肠球菌和屎肠球菌中未发现对万古霉素耐药的菌株。结论 该院常见病原菌耐药性较严重，临床医生应及时掌握细菌耐药情况以合理使用抗菌药物。

Investigation on antimicrobial resistance of bacteria isolated from a hospital from 2004 to 2005

Objective To investigate the bacterial distribution and antimicrobial resistance of clinical isolates from a hospital between January 2004 and December 2005.Methods Bacterial were isolated and identified by routine method,antimicrobial susceptibility tests of clinical isolates were performed using Kirby-Bauer method.Results Of 2 220 clinical isolates,gram-negative and gram-positive bacteria accounted for 1 310(59.01%) and 910(40.99%)respectively.ESBLs-producing strains accounted for 39.03% and 38.33% in Escherichia coli and Klebsiella pneumoniae.Imipenem and meropenem were the most potent antimicrobial agents against strains of Enterobacteriaceae.In the nonfermentative gram-negative bacilli,resistant rate of Pseudomonas aeruginosa to imipenem and meropenem was 27.86% and 29.66% respectively.Stenotrophomonas maltophilia was sensitive to cefoperazone-sulbactam and SMZ-TMP,drug-resistant rate was 45.15% and 17.74% respectively.In Staphylococcus aureus and coagulase negative Staphylococcus,MRSA and MRCNS accounted for 60.48% and 44.21% respectively,but all were sensitive to vancomycin.No Enterococcus faecalis and Enterococcus faecium strains resistant to vancomycin has been found.Conclusion The resistance of clinical isolates from the hospital is serious,so it is necessary to choose antimicrobial agents in the treatment of infection caused by pathogenic bacteria.