2013年长沙市妇幼保健院病原菌监测及细菌耐药性分析

目的 了解2013年长沙市妇幼保健院临床分离菌株对常用抗菌药物的耐药性。方法 对本院2013年临床分离的1882株细菌采用K‐B法进行抗菌药物敏感试验，按美国临床实验室标准化协会（CLSI）2013年版判断结果。结果 临床分离菌株共1882株，其中革兰阳性菌557株（29．60％），革兰阴性菌803株（42．67％），真菌522株（27．73％）；革兰阳性菌中，耐甲氧西林金黄色葡萄球菌（M RSA ）的检出率为32．94％；未发现耐万古霉素和利奈唑胺的金黄色葡萄球菌；表皮葡萄球菌对苯唑西林的敏感性较高，耐药率仅为9．68％；粪肠球菌对氨苄西林较敏感，耐药率为6．25％；无乳链球菌对氨苄西林均无耐药性；革兰阴性菌中，未发现产超广谱β‐内酰胺酶（ESBLs）的大肠埃希菌和肺炎克雷伯菌；卡他莫拉菌对氨苄西林舒巴坦的敏感性高达100％；流感嗜血杆菌对氨苄西林和氨苄西林舒巴坦的耐药率均为8．51％。结论 对细菌耐药性进行定期监测有助于了解细菌耐药性的变迁，为临床合理用药提供理论依据。

Surveillance of Pathogenic Bacterium and Analysis of Bacterial Resistance in Changsha Maternal and Child Health Hospital in 2013

Objective] To understand the resistance of clinical isolates obtained from Changsha maternal and child health hospital in 2013 to commonly used antimicrobial agents .Methods]Kirby‐Bauer（K‐B） method was used for anti‐bacterial drug susceptibility test of 1882 stains of bacteria isolated from our hospital in 2013 .According to 2013 national committee for clinical and laboratory standards institute（CLSI） ,the results were analyzed .Results] A total of 1882 pathogenic strains were clinically isolated and included 557 Gram‐positive bacteria（29 .60% ） ,803 Gram‐negative bacteria （42 .67% ） and 522 fungi（27 .73% ） .Among Gram‐positive bacteria ,the detection rate of methicillin resistant staphylo‐coccus aureus（MASA） was 32 .94% ,and vancomycin and linezolid‐resistant staphylococcus aureus were not found ,and the sensitivity of staphylococcus epidermidis to oxacillin was high（90 .32% ） ,and the Enterococcus faecalis was sensitive to ampicillin and the resistant rate was 6 .25% ,and the sensitivity of Streptococcus agalactiae to ampicillin was 100% .A‐mong Gram‐negative bacteria ,Escherichia coli and Klebsiella pneumonia producing the extended spectrum beta‐lactamases （ESBLs） were not found ,and the sensitivity of Moraxelle catarrhalis to Ampicillin and Sulbactam was 100% ,and the re‐sistance rate of Haemophilus influenzae to Ampicillin and Sulbactam was 8 .51% .Conclusion] Regular surveillance of bacterial drug resistance is helpful to understand the transition of bacterial drug resistance and can provide a theoretical ba‐sis for rational administration .