2005年安徽省细菌耐药性监测

目的 了解安徽地区临床分离菌株的耐药状况。方法 采用国际标准平皿琼脂对倍稀释法，对2005年9月份从安徽35家医院分离的1954株临床分离的非重复的各种细菌进行体外药敏实验，测定细菌的最低抑菌浓度（MIC），并按照美国临床实验室标准化研究所（CLSI）2005年版标准，计算细菌对抗菌药物的敏感率、中介率和耐药率。结果 1954株临床分离株中，革兰阳性菌占22．5％（439／1954），革兰阴性菌占77．5％（1515／1954）。在革兰阳性细菌中，耐甲氧西林金葡菌（MRSA）检出率为45．3％（621137），耐甲氧西林表葡菌（MRSE）检出率为87％（107／123），未发现耐糖肽类抗菌药物的葡萄球菌；未发现耐万古霉素肠球菌（VRE）。革兰阴性菌中，大肠埃希菌和克雷伯菌分别占26．9％（407／1515）和16．4％（248／1515），对头孢哌酮／舒巴坦和哌拉西林／三唑巴坦的敏感率明显高于其他头孢类抗菌药物；碳青霉烯类抗菌药物对革兰阴性菌的抗菌活性最强。结论临床上应合理应用抗菌药物。并应加强细菌耐药性监测，以防止细菌耐药性的蔓延。

Bacterial resistance surveillance in Anhui province in 2005

Objective To analyze the surveillance data on bacterial resistance in Anhui hospitals in September 2005.Methods Data on bacterial susceptibility testing of 1,954 clinical non-repeated isolates collected from 35 hospitals in Anhui was performed by routine custom dilution MIC method according to the CLSI(2005) guidelines,and detected the resistance,intermediate and susceptible rates of bacteria to antimicrobial agents respectively. Results Among 1,954 clinical isolates,Gram positive organisms and Gram negative organisms accounted for 22.5%(439/1,954) and 77.5%(1,515/1,954) respectively.Of Gram positive cocci,the detection rates of MRSA and MRSE were 45.3%(62/137) in Staphylococcus aureus and 87%(107/123) in coagulase negative Staphylococcus epidermidis respectively.No Gram positive cocci had resistance to glycopeptides antimicrobial agents.No VRE was found in Enterococcus.Of Gram negative bacilli,Escherichia coli and Klebsiella spp.accounted for 26.9%(407/1,515) and 16.4%(248/1,515) respectively.Susceptible rates of bacteria to cefoperazone-sulbactam and piperacillin-tazobactam were higher than other cephalosporins.Carbapenems were the most potent antimicrobial agents against Gram negative bacilli.Conclusions In order to control bacterial resistance,rationally choosing antimicrobial agents in the treatment of bacterial infections and strengthening efforts in monitoring of bacterial resistance were compulsory needed.