2011年四川省肿瘤医院细菌耐药性监测

目的了解2011年四川省肿瘤医院临床分离株对常用抗菌药物的耐药性.方法采用 MIC 法对1582株临床分离株进行药敏试验.按美国临床实验室标准化协会2009版判读结果.结果1582株临床分离株中革兰阳性球菌占10.1%(160/1582),革兰阴性杆菌占89.9%(1422/1582).耐甲氧西林金黄色葡萄球菌(MR‐SA)的检出率占金黄色葡萄球菌的26.1%.葡萄球菌中甲氧西林耐药株对β‐内酰胺类抗菌药物和其他测试药的耐药率显著高于甲氧西林敏感株,未发现万古霉素和利奈唑胺耐药株.肠球菌属中屎肠球菌对多数测试药物的耐药率高于粪肠球菌,出现1株耐万古霉素菌株,无利奈唑胺耐药株.革兰阴性肠杆菌中,大肠埃希菌和克雷伯菌属产ESBLs 株分别为66.5%和21.2%.产 ESBLs 菌株对大多β‐内酰胺类抗菌药物高度耐药.亚安培南对肠杆菌科细菌抗菌活性最强.出现了较多的多重耐药鲍曼不动杆菌.结论该院细菌耐药性较2010年有增长趋势,尤其出现了耐万古霉素的肠球菌且多重耐药鲍曼不动杆菌显著增多,应引起注意,并及早采取防控措施.

Surveillance of bacterial resistance from Sichuan cancer hospital in 2011

Objective To investigate the resistance of clinical isolates from Sichuan cancer hospital in 2011.Methods Antimicrobial susceptibility testing of 1 582 clinical isolates were carried out by means of MIC and results were analysed according to CLSI(2009).Results Of 1 582 clinical isolates,gram positive cocci and negative bacilli accounted for 10.1% and 89.9% respectively.Methicillin resistant strains in S.aureus(MRSA) accounted for 26.1%.The resistance rates of MRSA to β-lactams and other antimicrobial agents were much higher than those of methicillin-sensitive strains.No vancomycin or linezolid resistant strains were found.In Enter-ococcus spp,the resistance rates of E.faecium strains to most tested drugs were higher than those of E.faecalis.There was a strain resistant to vancomycin in E.faecium.No linezolid resistant strains were found.In enterobacteriaceae,ESBLs-producing strains accounted for 66.5% and 21.2% in E.coil and Klebsiella spp.respectively.ESBLs-producing strains were resistant to most β-lactams and some other antimicrobial agents.Imipenem was the most potent antimicrobial agent.Many multi-drug resistant strains in A.baumannii were found.Conclusion Bacterial resistance is still increasing in the hospital,especially VRE and multi-drug resistant A.baumannii strains.It is mandatory for the hospital to take effective control measures.