2009年401医院1802株分离株细菌药敏试验分析

目的调查分析2009年401医院临床分离常见病原菌对常用抗菌药物耐药情况。方法采用纸片扩散法进行药敏试验,按CLSI 2009年标准判定药敏结果并用WHONET5.4软件进行数据分析。结果 2009年401医院共分离细菌1 802株,其中革兰阴性杆菌1 373株,占76.19%,革兰阳性菌429株,占23.81%。MRSA和MRCNS检出率分别为69.36%和36.23%,未检测到万古霉素中介和耐药的葡萄球菌和肠球菌。大肠埃希菌、肺炎克雷伯菌和奇异变形杆菌ESBLs的发生率分别为71.43%、56.60%和29.03%,肠杆菌科细菌对碳青霉烯类(亚胺培南、美罗培南)仍高度敏感;铜绿假单胞菌对头孢他啶的耐药率最低,为11.9%;鲍曼不动杆菌对美罗培南、亚胺培南的耐药率较低,分别为30.9%、32.6%;6.93%鲍曼不动杆菌和3.11%铜绿假单胞菌为泛耐药株(只对多黏菌素敏感)。结论 2009年401医院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,应引起高度重视。

Surveillance and analysis on drug-resistance of 1802 strains bacterium in clinical isolates from the 401st hospital in 2009yr

Objective To investigate the drug-resistance of clinical isolates to antimicrobial agents commonly used in the 401st hospital during 2009yr.Methods Kirby-Bauer method was used to conduct susceptibility testing and the results were analyzed by WHONET 5.4 software according to CLSI 2009 stcmdard.Results Of the 1802 clinical isolates,76.19%(1 373/1 802) were gram-negative bacilli and 23.81%(429/1 802)were gram-positive cocci.The prevalence of methicillin-resistant Staphylococcus(MRS)was identified in 69.36% of S.aureus isolates and 36.23% of coagulase negative Staphylococcus.None of Staphylococcus or Enterococcus isolate was found resistant or intermediate to vancomycin.ESBLs were produced in 71.43% of E.coli,56.60% of K.pneumoniae and 29.03% of Proteus mirabilis isolates respectively.Enterobacteriaceae strains were highly susceptible to imipenem and meropenem.One strain of E.cloacae was resistant to carbapenems in 2010.The resistance rate of P.aeruginosa was the lowest to ceftazidime(11.9%).About 30.9% and 32.6%of Acinetobacter baumannii isolates were resistant to meropenem and imipenem.About 6.93% of A.baumannii and 3.11% of P.aeruginosa isolates were panresistant strains(only sensitive to colistin).Conclusion Gram-negative bacilli were dominant isolates in author's hospital during 2009.P.aeruginosa is the most frequently isolated pathogen.Carbapenems are highly active against Enterobacteriaceae.Special attention should be paid to the serious antimicrobial resistance in increasing non-fermenting gram-negative bacilli.