2005年广州医学院第一附属医院细菌耐药性监测

目的调查广州医学院第一附属医院2005年临床分离菌对各种抗菌药物的耐药现状。方法药敏试验采用纸片扩散法,数据分析采用WHONET5.4软件。结果2005年我院共收集患者首次分离株1843株,其中革兰阳性菌507株(27.51%),革兰阴性菌1336株((72.49%)。MRSA和MRCNS的检出率分别为71.7%和87.6%。粪肠球菌对呋喃妥因、氨苄西林的敏感率分别为88.0%和73%。未出现万古霉素和替考拉宁中介和耐药的葡萄球菌和肠球菌。肠杆菌科细菌对亚胺培南和美罗培南均极敏感,耐药率最低。大肠埃希菌和肺炎克雷伯菌中ESBLs的检出率分别为36.6%和56.1%。鲍曼不动杆菌对亚胺培南和美罗培南的敏感率分别为98.8%和90.2%。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为48.0%和39.2%,14.0%菌株对所有检测药物耐药。结论我院2005年临床分离菌以革兰阴性菌为主,铜绿假单胞菌位居第一。肠杆菌科细菌对碳青霉烯类的敏感性最高,非发酵菌数量呈上升趋势,且耐药状况严重,14%铜绿假单胞菌对所有检测药物耐药。

Surveillance of antibiotic resistance in clinical isolates from First Affiliated Hospital of Guangzhou Medical College in 2005

Objective To investigate the antimicrobial resistance of clinical isolates in First Affiliated Hospital of Guangzhou Medical College during 2005.Methods Disc diffusion test was employed to study the antimicrobial resistance.WHONET 5.4 software was used for data analysis.Results A total of 1 843 non-duplicate isolates were collected in 2005.Gram positive microorganisms accounted for 27.51%(507/1 843).Gram negative bacteria accounted for 72.49%(1 336/1 843).The prevalence of methicillin-resistant Staphylococcus(MRS)was identified in 71.7% of S.aureus isolates and 87.6% of coagulase negative Staphylococcus.About 88.0% and 73% of E.faecalis isolates were susceptible to furantoin and ampicillin respectively.None of Staphylococcus or Enterococcus isolate was found resistant or intermediate to vancomycin or teicoplanin.Enterobacteriaceae strains were highly susceptible to imipenem and meropenem with the lowest resistance rate.ESBLs were detected in 36.6% of E.coli and 56.1% of K.pneumoniae isolates,respectively.About 98.8% and 90.2% of A.baumannii isolates were susceptible to imipenem and meropenem respectively.About 48.0% and 39.2% of P.aeruginosa isolates were resistant to imipenem and meropenem respectively.About 14% of the P.aeruginosa isolates were resistant to all the antimicrobial agents tested.Conclusions Gram-negative bacilli were dominant isolates in our hospital during 2005.P.aeruginosa is the most frequently isolated pathogen.Carbapenems are highly active against Enterobacteriaceae.Non-fermentative microorganisms are increasing with heavy resistance.Fourteen percent of the P.aeruginosa isolates were resistant to all the antimicrobial agents tested.