【摘要】 目的分析海口市人民医院2012年临床分离细菌对抗菌药物的耐药趋势。方法用VITEK 2compact鉴定仪对细菌进行鉴定,采用纸片扩散法(K-B法)、仪器法和E-test法对2012年度临床分离菌株分别进行药敏试验,结果按CLSI 2012年版标准判读,用WHONET5.6软件进行耐药性分析。结果 2012年共收集非重复临床分离菌株3746株,其中革兰氏阴性菌占78.8%(2950/4746),革兰氏阳性菌占21.2%(796/3746)。MRSA和MRCNS检出率分别为35.4%和69.9%,未发现对万古霉素和利奈唑胺耐药的葡萄球菌和肠球菌。肺炎链球菌中青霉素耐药株(PRSP)为26.7%。β溶血链球菌对万古霉素、青霉素、氨苄西林和头孢吡肟均高度敏感。大肠埃希菌和肺炎克雷伯菌中ESBLs阳性率分别为59.0%和35.8%,发现对亚胺培南和美罗培南耐药的大肠埃希菌3株和肺炎克雷伯菌2株。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为17.6%和14.5%。鲍曼不动杆菌对11种抗生素的耐药率均在30%以下。左氧氟沙星和复方新诺明对嗜麦芽窄食单胞菌有较好的抗菌活性(耐药率<10%)。结论 2012年该院分离的细菌主要以革兰氏阴性杆菌为主,临床分离细菌对常用抗菌药物呈不同程度的耐药,未检出对万古霉素耐药的肠球菌和葡萄球菌,肠杆菌科细菌对碳青霉烯类药物呈较低水平耐药状态,应继续做好对该类药物的保护。更多还原

【Abstract】 Objective To investigate the resistance of clinical isolates of bacteria in Haikou People’s Hospital in 2012.Methods Bacteria were identified by VITEK 2 compact instrument,and antimicrobial susceptibility testing was carried out by Kirby-Bauer(K-B)method,instrument and E-test.Then the data was analyzed by WHONET 5.6 software according to CLSI 2012 breakpoints.Results Of the 3 746 clinical isolates collected in 2012,gram-negative bacilli and gram-positive bacilli accounted for 78.8%(2 950/3 746)and 21.2%(796/3746),respectively.The detection rates of the meticillin-resistant Staphylococcus aureus(MRSA)and coagulase-negative Staphylococcus(MRCNS)were 35.4% and 69.9%.Neither vancomycin nor linezolid resistant isolate was found in Staphylococcus.The rate of penicillin-resistant Streptococcus pneumoniae(PRSP)was 26.7%.Beta-hemolytic Streptococcus was found highly sensitive to vancomycin,penicillin,ampicillin and Levofloxacin.ESBLs positive rates of E.coli and K.pneumoniae accounted for 59.0% and 35.8%.Three E.coli strains and 2 K.peumoniae isolates were resistant to imipenem and meropenem.The resistance rate of Pseudomonas aeruginosa to imipenem and meropenem were 17.6% and 14.5%,respectively.The resistance rates of Acinetobacter baumannii to 11 antibiotics were all below 30%.Stenotrophomonas maltophilia was sensitive to levofloxacin medicine and Sulfamethoxazole-trmethoprim(drug-resistant rate<10%).Conclusion Gram-negative bacilli are the most common isolates in our hospital in 2012.No Vancomycin-resistant isolates were detected in Enterococci and Staphylococcus.Carbopenems-resistant isolates in Enterobacteriaceae were detected in our surveillance,which should be noted.更多还原