【摘要】 目的　了解我院临床分离菌的分布及其耐药性。方法　采用 Microscan WalkAway 40 全自动微生物鉴定仪及配套阳性菌和阴性菌药敏复合板进行菌种鉴定与药敏试验,根据NCCLS标准对肠球菌属细菌重新进行万古霉素耐药表型筛选与确证试验。结果　2002年1月至2003年12月我院共分离1 947 株菌株,其中革兰阳性球菌 609 株(31.3%),革兰阴性杆菌1 338株(68.7%)。金黄色葡萄球菌(SA)和凝固酶阴性葡萄球菌(CNS)中甲氧西林耐药株(MRSA和MRCNS)各占65.3%和70.7%,未发现万古霉素耐药株和中介株。肠球菌属中粪肠球菌和屎肠球菌万古霉素耐药株(VRE)各占5.6%和3.7%,中介株(VIE)各占15.7%和11.1%。SA、CNS和肠球菌属对万古霉素敏感率最高,其次为呋喃妥因。大肠埃希菌、克雷伯菌属、肠杆菌属、变形杆菌属、铜绿假单胞菌和不动杆菌属对亚胺培南耐药率除铜绿假单胞菌为10.5%外,其余菌属仅0.0%~3.8%,对头孢他啶、头孢曲松、头孢噻肟和头孢泊肟的耐药率除变形杆菌属较低外分别达18.9%~38.6%、27.1%~57.9%、31.0%~55.3%和25.9%~61.4%;大肠埃希菌对环丙沙星耐药率为66.7%。结论　临床上MRSA、MRCNS和肠球菌属感染常见,目前细菌耐药现象仍然严重,应合理应用抗生素以延缓细菌耐药性的产生。更多还原

【Abstract】 ObjectiveTo investigate the distribution and resistant of clinical isolates in our hospital during 2002-2003.MethodsBacterial identification and antibiotic susceptibility tests were carried out using Microscan WalkAway- 40 system and susceptibility testing plates for gram positive and gram negative organisms.Vancomycin resistance isolates of Enterococci spp.were identified using screening and confirmatory methods recommended by the National Committee for Clinical Laboratory Standard (NCCLS).ResultsAmong 1 947 clinical isolates collected between January 2002 and December 2003 in our hospital,gram-positive cocci and gram-negative bacilli accounted for 31.3% (609/1 947) and 68.7% (1 338/1 947) respectively.Methicillin-resistant strains (MRSA and MRCNS) accounted for 65.3% of S.aureus (SA) and 70.7% of coagulase-negative staphylococci (CNS) respectively.No vancomycin-resistant (VRE) or -intermediate (VIE) strains were found in staphylococcus isolates.About 5.6% of S.faecalis and 3.7% of S.faecium were VRE.About 15.7% of S.faecalis and 11.1% were VIE.Vancomycin was the most active antibiotic against SA,CNS and Enterococci spp.,followed by nitrofurantoin.The resistance rates of E.coli,Klebsiella spp.,Enterbacter spp.,Acinetobacter spp. and Proteus spp. to imipenem were only 0%- 3.8%,but 10.5% of P.aerugonisa isolates were resistant to imipenem.The resistance rates of gram-negative isolates to ceftazidime,ceftriaxone,cefotaxime and cefpodoxime were 18.9%-38.6%,27.1%-57.9%,31.0%-55.3%,and 25.9%-61.4% with the exception of relatively susceptible Proteus spp..The resistance rate of E.coli to ciprofloxacin was 66.7%.ConclusionsInfections caused by MRSA,MRCNS and Enterococcus spp. are common in patients.The situation of bacterial resistance is still serious.Therefore,the rational use of antibiotics is important for the containment of bacterial resistance.更多还原