【摘要】 目的了解2017年内蒙古包头市临床分离菌对常用抗菌药物的耐药情况。方法对2017年内蒙古包头市11所参加全国细菌耐药监测网医院所有临床分离菌,采用纸片扩散法或自动化仪器法按统一方案进行抗菌药物敏感性试验。结果共收集上述医院非重复临床分离菌7922株,其中革兰阳性菌2081株,占26.3%,革兰阴性菌5841株,占73.7%。MRSA和MRCNS的检出率分别占各自菌的15.6%和75.7%,MRSA和MRCNS对大多数抗菌药物的耐药率均显著高于MSSA和MSCNS,未发现对利奈唑胺、万古霉素和替考拉宁耐药的葡萄球菌。屎肠球菌对大多数抗菌药物的耐药率均显著高于粪肠球菌。非脑膜炎肺炎链球菌儿童株和成人株对红霉素、四环素和克林霉素的耐药率均较高。大肠埃希菌、克雷伯菌属和奇异变形杆菌中产ESBL菌株的检出率分别占各自菌的49.8%、17.2%和35.9%,产ESBL菌株对所测抗菌药物的耐药率均高于非产ESBL菌株。大肠埃希菌对喹诺酮类抗菌药物耐药率均在60.0%以上。CRE的检出率为1.1%,对阿米卡星耐药率最低,为34.4%。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为16.1%和14.4%;不动杆菌对亚胺培南和美罗培南的耐药率分别为26.3%和21.4%。结论该市耐药形势严峻,应及时全面了解且利用当地细菌耐药性监测结果进行院感管理防控,同时必须加强抗菌药物的合理规范使用。更多还原

【Abstract】 Objective To investigate the resistance profile of clinical bacterial isolates to commonly used antimicrobial agents in Baotou, Inner Mongolia during 2017. Methods A total of 11 hospitals in Baotou, Inner Mongolia participated in the China Antimicrobial Resistance Surveillance System(CARSS). The susceptibilities of all clinical isolates in 2017 to antimicrobial agents were determined by Kirby-Bauer method or automated systems according to a unified protocol. Results A total of 7 922 nonduplicate clinical isolates were collected from the participating hospitals, of which grampositive cocci and gram-negative bacilli accounted for 26.3% and 73.7%, respectively. The prevalence of methicillin-resistant strains was 15.6% in S. aureus(MRSA) and 75.7% in coagulase-negative Staphylococcus(MRCNS), respectively. The resistance rates of methicillin-resistant strains(MRSA and MRCNS) to most commonly used antimicrobial agents were significantly higher than those of methicillin-sensitive strains(MSSA and MSCNS). No staphylococcal strains were found resistant to linezolid, vancomycin or teicoplanin. The resistance rate of Enterococcus faecium to most of the antimicrobial agents tested was significantly higher than that of Enterococcus faecalis. The resistance rates of non-meningitis S. pneumoniae isolated from children and adults to erythromycin, tetracycline and clindamycin were higher. The prevalence of ESBLs-producing strains was 49.8% in E. coli, 17.2% in Klebsiella spp. and 35.9% in Proteus mirabilis. ESBLs-producing Enterobacteriaceae strains were more resistant than non-ESBL-producing strains in term of antibiotic resistance rate. The resistance rate of E. coli to quinolones was above 60.0%. The prevalence of CRE was 1.1%. The CRE strains had the lowest resistance to amikacin, which was 34.4%. The resistance rates of P. aeruginosa to imipenem and meropenem were 16.1% and 14.4%, respectively. The resistance rates of Acinetobacter to imipenem and meropenem were 26.3% and 21.4%, respectively. Conclusions The antibiotic resistance situation in Baotou, Inner Mongolia is also very serious. Attention should be paid to the surveillance of bacterial resistance in this area for better prevention and control of hospital infections. Measures must be taken to enhance rational use of antimicrobial agents.更多还原