3170株临床分离病原菌耐药谱与耐药机制的研究

目的了解医院临床分离病原菌的耐药谱与耐药机制,为合理用药提供依据。方法分离的病原菌用API和Microscan鉴定,药敏用K-B法,数据分析用WHONET5.4软件。结果3170株病原菌中前5位为铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌、大肠埃希菌、金黄色葡萄球菌,分别为24.3%、10.9%、10.4%、8.9%、8.0%;在G^-杆菌中,美罗培南耐药率最低（19.7%）,哌拉西林/他唑巴坦耐药率为26.5%,大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶（ESBLs）阳性率分别为49.1%和33.5%;G^＋球菌中,万古霉素和替考拉宁敏感率均为100.0%,金黄色葡萄球菌和凝固酶阴性葡萄球菌耐苯唑西林分别为54.2%和82.3%。结论医院临床分离病原菌产ESBLs和耐苯唑西林比率高,应加强抗菌药物的合理使用和采取有效的隔离措施以降低耐药率及多药耐药菌的扩散。

Drug Susceptibility and Resistant Mechanisms of 3170 Strains of Clinical Isolates

OBJECTIVE To investigate the drug susceptibility of clinical isolates in local region for using antibiotic reasonably. METHODS Totally 3 170 strains of clinical isolates were identified by API and Microscan and tested for drug resistance against antimicrobial agents by K-B method. WHONET5.4 was applied for analysis. RESULTS The commonly encountered bacteria were Pseudomonas aeruginosa (24.3%), Acinetobacter baumannii (10.9%), Klebsiella pneumoniae (10.4%), Escherichia coli (8.9%), and Staphylococcus aureus (SA,8.0%). In Gram-negative isolates, the resistance rate to meropenem was 19.7%, and to piperacillin-tazobactam was 26.5%. The incidences of E.coli and K. pneumoniae isolates producing extended spectrum beta-lactamases (ESBLs) were 49.1% and 33.5%, respectively. In Gram-positive isolates, the susceptibility rate to vancomycin and teicoplanin both was 100.0%. The oxacillin resistant rates of SA and coagulase negative Staphylococcus (CNS) were 54.2.0% and 82.3%. CONCLUSIONS The production ratio of ESBLs and oxacillin resistance of bacteria in local region are high. It is important to promote the rational use of antimicrobial agents and take effective contaminant methods to reduce resistant rates of bacteria and dissemination of multi-resistant bacteria.