2001年我院临床分离菌耐药性监测

目的：调查2001年我院临床分离致病菌对常用抗生素的耐药状况。方法：排除同一病人相同部位先后分离的重复菌株，共收集2001年1月至12月我院临床分离致病菌853株，采用Kirby-Bauer法进行纸片药敏试验，按NCCLS2000年标准判断结果，利用WHONET5软件进行统计和分析。结果：最常见的革兰阳性菌为金黄色葡萄球菌和凝固酶阴性葡萄球菌，其甲氧西林耐药株分别占28％和57％，示发现耐万古霉素的葡萄球菌；最常见的革兰阴性菌为铜绿假单胞菌，大肠埃希菌，鲍曼不动杆菌，肺炎克雷伯菌，阴沟肠杆菌和嗜麦芽窄食单胞菌等。其中大肠埃希菌对氟喹诺酮类药物，哌拉西林和庆大霉素的耐药率接近50％或达50％以上；阴沟肠杆菌和弗劳地枸橼酸杆菌对头孢菌素的耐药率明显增高；铜绿假单胞菌对头孢他啶的耐药率为9％，但对亚胺培南的耐药率已增高至26％，嗜麦芽窄食单胞菌对头孢他啶和亚胺培南的耐药率高达17％和87％，应引起临床高度重视。结论：细菌耐药率呈上升趋势，多重耐药也日趋严重，故开展细菌耐药性监测，及时掌握细菌耐药性变迁动态，对指导临床合理应用抗生素，积极有效地控制医院感染具有重要意义。

Surveillance of Bacterial Resistance of Clinical Isolates from West China Hospital in 2001

Objective:To investigate the rates of bacterial resistance to common used antibiotics of clinical isolates obtained from West China Hospital in 2001.Methods:853 clinical isolates were collected from January to December,2001.Bacterial susceptibility tests were performed using Kirby-Bauer method and the results were analyzed according to NCCLS(2000)by WHONET5 software.Results:S.aureus and coagulase negative staphylococci(CNS)were the main Gram-positive microorganisms.Methicillin resistant strains accounted for 28% and 57% of S.aureus and CNS respectively;and no vancomycin resistant strains were found.The main Gram-negative microorganisms included P.aerugiinosa,E.coli,A.baumanuii,K.pneumoniae,E.cloacae and S.maltophi.Resistant rates of E.coli against fluoroquinolones,piperacillin and gentamycin were about 50% or higher.Resistant rates of E.cloacae and C.freundii against cephalosporins had increased markedly.The resistant rate of P.aeruginosa against ceftazidime was 9%,but the rate against imipenem had increased to 26%.Besides,the resistant rates of S.maltophi against ceftazidime and imipenem had increased to 17% and 87% respectively. We must pay close attention to it.Conclusion:The rates of bacterial resistance are increasing and multi-drug resistance(MDR)is a serious problem.It is important and urgent to carry out surveillance of bacterial resistance for appropriate using of antibiotics and effective controlling nosocomial infections.