2004-2005年住院患者细菌耐药监测研究

目的 监测和探讨我国不同地区的8所医院感染患者中分离细菌的耐药情况.方法 按照设计方案对7所医院从2004年9月1日至2005年8月31 日内分离的1 111株致病菌采用国际标准琼脂稀释法进行体外敏感试验,按照美国临床和实验室标准协会(CLSI)2007年的标准测定MIC,以MIC50和MIC90表示抗菌药物的抗菌活性,并计算出耐药率(R%)、中介率(I%)和敏感率(S%).结果 检测到的耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林表皮葡萄球菌(MRSE)分别为39.3%和74.0%.未发现MRSA或MRSE对万古霉素耐药菌株.耐青霉素肺炎链球菌的总耐药率为33.3%(R%5.6%,1%27.7%).肠球菌91株,耐青霉素粪肠球菌40.8%,而耐青霉素屎肠球菌为100%.尚未发现对万古霉素耐药的肠球菌.分离到644株革兰阴性菌.最常见的细菌依次为;大肠埃希菌、肺炎克雷伯菌、不动杆菌、铜绿假单胞菌和阴沟肠杆菌.在大肠埃希菌和肺炎克雷伯菌中,产超广谱酶菌各占38.6%和26.7%.碳青霉烯类美罗培南、亚胺培南是所测定抗菌药物中对肠杆菌科细菌作用最强的抗牛素.多数革兰阴性杆菌对头孢哌酮/舒巴坦和头孢吡肟有很高敏感率.三代头孢中的头孢他啶对多数革兰阴性杆菌仍有很高敏感率.新喹诺酮类的莫西沙星、左氧沙星对革兰阳性和阴性菌均有很强的广谱抗菌作用.结论 本次监测(2004-2005年)与2002-2003年度监测结果显示,在致病菌的耐药类型和某些菌耐药增长趋势方面基本相似.

Surveillance on drug resistance of bacteria isolated from hospitalized-patients in 2004-2005

Objective To determine the drug-resistance rates of bacteria isolated from 7 hospitals located at different areas of China.Methods 1 111 pathogenic strains were isolated for susceptibility test using agar dilution method from Sep 1,204 to Aug 3 1,2005.According to the criteria of guideline of CLSI (2007),MIC50 and MIC90 were detected for antibacterial activity of antimicrobial agents and resistant rate (R%),intermediate rate(I%)and sensitive rate(S%)were calculated based on susceptibility tests.Results The detectable rates of methiciltin-resistant Staphylococcus anreus(MRSA)and methicilllin- resistant Staphylococcus epidermidis(MRSE)were 39.3%and 74.0% respectively.The total resistant rate of penicillin resistant Streptococcus pneumoniae(R%+I%) was 33.3%(R%=5.6%,I%=27.7%). 91 strains of Enterococcus were isolated.The resistant rate of penicillin resistant E.faecalis Was 40.8%.and E.faecium Was 100%.Neither strains of S.aureus nor strains of S.epidemidis were found resistant to vancomycin.No strains of Enterococcus were found resistant to vancomycin.644 strains of gram-negative bacilli were isolated.The most common gram-negative bacilli were E.coli,k pneumoniae,Acinetobacter spp,P.aeruginosa,and E.cloacae,respectively.The ESBLs-producing strains accounted for 38.6% and 26.7% in E.coli and K. pneumoniae.respectively.Meropenem and imipenem were the most potent antimicrobial agents.Cefoperazone/sulbactam demonstrated excellent activity agent of gram-negative bacilli.Most of the gram-negative bacillus still susceptible to ceftazidime.The new fluroquinotones, moxifloxacin and levofloxacin showed strong and broad spectrum activity against the most gram-positive and gram-negative bacteria.Conclusions This surveillance in 2004-2005 together with the surveillance in 2002-2003,were similar in the bacterial resistance pattern and the trend of rising resistant rates for some pathogens.