Mohnarin 2009年度报告:四川地区细菌耐药监测

目的了解2009年度四川地区医院临床分离细菌的构成和对常用抗菌药物的耐药特征,指导临床合理使用抗菌药物。方法四川地区3家医院临床分离菌株按统一方案进行抗菌药物敏感试验,依据2009年CLSI标准,采用WHONET5.5软件进行数据分析。结果 3家医院各种临床标本中分离菌株共2693株,其中革兰阳性菌684株(25.4%),革兰阴性菌2009株(74.6%)。葡萄球菌中MRSA和MRCNS检出率分别为93.1%和71.4%,未发现对万古霉素、利奈唑胺及替考拉宁不敏感株,但凝固酶阴性葡萄球菌对替考拉宁耐药率为1.1%。粪肠球菌对万古霉素高度敏感,屎肠球菌对万古霉素耐药率为2.8%。大肠埃希菌和肺炎克雷伯菌产ESBLs菌株检出率分别为37.3%和23.6%。各种肠杆菌科细菌均对亚胺培南高度敏感。铜绿假单胞菌、鲍曼不动杆菌对美罗培南的耐药率分别为21.2%和58.6%。嗜麦芽窄食单胞菌对左氧氟沙星较敏感。结论通过监测临床致病菌的分布特点和耐药性变迁,对指导临床合理使用抗生素,控制医院感染和细菌耐药性发展有重要意义。

BacteriaI distribution and resistance in sichuan

Objective To investigate the distribution and drug resistance of clinical isolates in sichuan in 2009.Methods The susceptibility testing of clinical isolates from 3 hospitals of Sichuan were performed according to the standard method.Results Were analyzed by WHONET 5.5 according to CLSI 2009.results a total of 2693 clinical isolates were collected,Gram positive microorganisms and Gram negative accounted for 25.4% and 74.6% respectively.Aureus in the detection rate of MRSA and MRCNS was 93.1% and 71.4% were not found to vancomycin,linezolid and teicoplanin is not sensitive strains,but coagulase-negative staphylococci resistant rate of teicoplanin is 1.1%.Enterococcus faecalis highly sensitive to vancomycin,2.8% of Enterococcus feces of clinical isolates were resistant to vancomycin.Escherichia coli and Klebsiella pneumoniae which are strains producing ESBLs were detected in 37.3% and 23.6%.A variety of Enterobacteriaceae were highly sensitive to imipenem.The Percentage of Pseudomonas aeruginosa and Acinetobacter baumannii which were resistant to meropenem were 21.2% and 58.6%.Stenotrophomonas maltophilia is more sensitive to levofloxacin.Conclusion It is of great importance to guide the rational use of antibiotics in clinic and cont rol the infections within the hospital as well as the bacterial resistance to antibiotics development through mornitoring the dist ributionof pathogenic bacteria and the clinical characteristics and the changes of drug resistance.