郴州地区临床感染患者致病菌分布特点及耐药性分析

目的了解郴州地区各医院临床致病菌的分布特点和对常用抗菌药物的耐药情况,为医生临床选药提供实验依据。方法 2006年1月-2010年12月期间郴州地区12家医院细菌室收集的临床感染患者各类标本,分纯细菌后均在惠州阳光公司半自动分析系统中进行细菌鉴定和药敏试验,对结果资料进行统计分析。结果 5年来分离22 327株细菌。主要阴性杆菌对一、二代头孢菌素的耐药率普遍超过了70%,对第三代头孢菌素和头孢吡肟耐药率超过了50%;对碳青霉烯类抗生素和含β-内酰胺酶抑制剂的复方制剂保持较高敏感性,大肠埃希菌、肺炎克雷伯菌产ESBLs株的比例为39.1%和44.0%。葡萄球菌对青霉素和氯霉素耐药严重,达91.6%,对头孢类和喹诺酮类耐药率为30%~60%,未发现万古霉素耐药株,MRSA和MRSCN分离率分别为54.9%和42.0%。链球菌对大环内脂类耐药率高于50%外,对其余类敏感。肠球菌对氯霉素、利福霉素、万古霉素等耐药率小于30%外,对其它类抗菌素耐药率较高。发现多重耐药细菌13 957株,分离率62.5%。结论郴州地区临床感染患者各类标本中细菌耐药严重,特别是多重耐药菌分离高,应引起郴州地区各级卫生行政管理部门的高度重视。

Analysis on Distribution Characteristics and Drug Resistance of Pathogenic Bacteria Isolated form Clinical Infection Patients in Chenzhou Region

Objective To investigate the distribution features and the drug resistance pattern of pathogenic bacteria isolated from clinical patients of hospitals in Chenzhou region,and to provide the evidence for rational use of antibiotics in clinical practice. Methods Various specimens for culture were collected from clinical infection patients hospitalized in 12 hospitals of Chenzhou region from January 2006 to December 2010.Bacterial identification and antibiotic susceptibility testing were performed using semi-automatic analysis system produced by Huizhou Sunshine Biological Corporation.And all the result data were statistically analyzed. Results A total of 22,327 strains of bacteria were separated during the five-year period.The drug resistance rates of the principal gram-negative bacilli to first-and second-generation cephalosporin were generally more than 70%,and those to third-generation cephalosporin and cefepime were more than 50%.The principal gram-negative bacilli were highly susceptible to carbapenems and compound preparation containing Beta-lactamase inhibitor.The ratios of ESBLs-producing Escherichia coli and Klebseilla pneumonia were 39.1% and 44.0%,respectively.The drug resistance rate of staphylococcus for penicillin and chloramphenicol reached 91.6%.The resistance rates to cephalosporin and quinolone were 30%～60%.No vancomycin resistant strains were found.The separated rates of MRSA and MRSCN were 54.9% and 42.0%,respectively.The resistance rate of streptococcus to macrolideantibiotic was above 50%;moreover,streptococcus was susceptible to the other antibiotics.The drug resistance rates of enterococcus for chloramphenicol,vancomycin,and rifamycin were less than 30%,but higher resistant rates for other antibiotics were found.13,957 strains of multiple drug-resistant bacteria were detected,with the separated rate of 62.5%. Conclusions The drug resistance of bacteria isolated from various specimens collected from clinical infection patients in Chenzhou region is serious,especially the higher isolated rates of multiple drug-resistant bacteria.Special attention should be paid to this issue by all kinds and all levels of medical administrative departments.