【摘要】 目的了解女性生殖道细菌感染常见病原菌及其对抗菌药物的耐药性。方法用纸片扩散法对1990—2009年北京协和医院女性生殖道细菌感染分离的3840株病原菌进行抗菌药物耐药监测,按CLSI2009年版标准判读药敏结果,采用WHONET5.4软件进行数据分析。结果 20年来北京协和医院女性生殖道细菌感染以大肠埃希菌检出率最高(25%),其次为凝固酶阴性葡萄球菌(17%),粪肠球菌(14%),无乳链球菌(10%)和金黄色葡萄球菌(7%)。产超广谱β-内酰胺酶(extended-spectrum beta-lactamases,ESBLs)的大肠埃希菌检出率为24%。产ESBLs大肠埃希菌对亚胺培南、美罗培南和厄他培南均100%敏感,对阿米卡星、哌拉西林/三唑巴坦、头孢西丁的敏感率均>80%。肠杆菌科中的不同菌种对碳青霉烯类抗菌药物均100%敏感,对阿米卡星的敏感率均较高(86.4%~98%)。凝固酶阴性葡萄球菌和金黄色葡萄球菌对万古霉素和替考拉宁的敏感率均为100%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)对β-内酰胺类和其他抗菌药物的耐药率较耐甲氧西林金黄色葡萄球菌(MRSA)低。粪肠球菌对万古霉素、替考拉宁、青霉素、氨苄西林、呋喃妥因和磷霉素的耐药率均低于10%,未发现万古霉素和替考拉宁耐药的肠球菌。无乳链球菌对青霉素、古霉素和头孢吡肟也保持很高活性。结论女性生殖道细菌感染最常见的病原菌是大肠埃希菌,应加强细菌耐药监测,指导临床合理使用抗菌药物。更多还原

【Abstract】 Objective To investigate the common pathogens distribution and antimicrobial resistance of female genital tract infections isolates in peking union medical college hospital(PUMCH).Methods A total of 3840 clinical isolates were collected from female genital tract infections in PUMCH from 1990 to 2009.Antimicrobial susceptibility testing was carried out by disk diffusion method.The date were analyzed by WHONET 5.4 software according to CLSI2009.Results The most common pathogens identified were E.coli(25%),followed by coagulase negative Staphylococcus(17%),Enterococcus faecium(14%),Streptococcus agalactiae(10%),and Staphylococcus aureus(7%).Detection rates of ESBLs-producing strains in E.coli was 24%.Imipenem,meropenem and ertapenem showed excellent activity against ESBLs-producing strains in E.coli.The susceptibility of ESBLs-producing E.coli to amikacin,piperacillin-tazobactam and cefoxitin were higher than 80%.The different species in Enterobacteriaceae were highly susceptible to imipenem,meropenem and ertapenem(susceptible rate,100%),follow by amikacin(86.4%~98%).Vancomycin and teicoplanin showed excellent activity against coagulase negative Staphylococcus and Staphylococcus aureus.The resistance rates of MRCNS strains to β-lactams and other antimicrobial agents were lower than that of MRSA.The resistence rates of E.faecalis to vancomycin,teicoplanin,penicillin,ampicillin,nitrofurantoin and fosfomycin were less than 10%.No vancomycin and teicoplanin resistant enterococcus strains(VRE) were found.Penicillin,vancomycin and cefepime showed the most active agents against Streptococcus agallactiae.Conclusion E.coli is the most common pathogen,we must strengthen monitoring of drug resistance for rational antimicrobial therapy.更多还原