【作者】 应华永； 卜黎红； 朱以军； 赵硕； 张丽英； 徐瑞龙；

【Author】 Ying huayong Bo lihong Zhu yijun Zhao shuo Zhang Hying Xu ruilong Dept.of Clinical Laboratory,Jinhua Municipal Central Hospital,ZheJiang(321000)

【机构】 金华市中心医院检验科；

【摘要】 目的了解金华市中心医院2009年临床分离菌对各类抗菌药物的耐药性。方法纸片扩散法(Kirby-Bauer法)检测临床分离菌对各类抗菌药物的敏感性,判断标准参照2007年版CLSI文件。结果临床分离2224株细菌中,革兰阴性菌占75.7%,革兰阳性菌占24.3%。甲氧西林耐药的金黄色葡萄球菌(MRSA)和凝固酶阴性的葡萄球菌(MRCNS)分别占51.2%(74/143)和91.5%(193/211),其中仍有74.3%的MRSA对磺胺甲噁唑敏感,88.4%的MRCNS对利福平敏感。肠球菌属中屎肠球菌的检出率52.1%(49/94),首次高于粪肠球菌的检出率25.5%(24/94)。屎肠球菌对多数测试药的耐药率高于粪肠球菌,但对氯霉素的耐药率相反。大肠埃希菌和克雷伯菌中ESBLs检出率分别为53.8%(252/4.68)和43.1%(187/434)。不动杆菌属对头孢哌酮/舒巴坦较敏感(耐药率12%),对亚胺培南、美罗培南的耐药率分别为52.4%、60.2%;铜绿假单胞菌对两者的耐药率分别为9.6%、9%。米诺环素对嗜麦芽窄食单胞菌和洋葱伯克霍尔德菌有良好的抗菌活性,敏感率均>95%。出现7株泛耐药的铜绿单胞菌和5株泛耐药的鲍曼不动杆菌。结论我院细菌的耐药现状比较严峻,尤其是泛耐药的不发酵糖革兰阴杆性菌的增多,应引起重视,并及早采取防控措施。更多还原

【Abstract】 Objective To investigate the resistance of clinical isolates from Jinhua municipal central hospital in 2009.Methods Antimicrobial susceptibility test was carried out by Kirby-bauer method, results were analyzed according to CLSI 2007.Results Of 2224 clinical isolates,gram negative bacilli and gram positive cocci was accounted for 75.7%and 24.3%respectively.Methicillin resistant strains in S.aureus(MRSA) and coagulase negative staphylococcus(MRCNS) accounted for 51.2% (74/143) and 91.5%(193/211) respectively.However,about 74.3%of MRSA strains were still susceptible to sulfamethoxazole-trimethoprim and 88.4%of MRCNS strains were still susceptible to rifampin.In Enterococcus spp,the detection rates of E.faecium strains 52.1%(49/94) were higher than E.faecalis strains 25.5%(24/94) firstly.The resistant rates of E.faecium strains to most of drugs were higher than those of E.faecalis,however the resistant rates of the later strains to chloramphenicol was higher.ESBLs- producing strains accounted for 53.8%(252/468) in E.coli and 43.1%(187/434) in Klebsiella spp.Altough acinetobacter spp were still highly susceptible to Cefoperazone-sulbactam, resistance rates to imipinem and meropinem were 52.4%and 60.2%respectively.The resistance rates of P.aeruginosa strains to imipinem and meropinem were 9.6%and 9%respectively.Minocycline had good activity against S.maltophilia and burkholderia spp.The isolates susceptible to minocycline were both higher than 95%.7 strains of pan-resistance P.aeruginosa and 5 strains of pan-resistance of A.baunmnnii were found.Conclusions:The bacteria resistance is fairly severe in our hospital,specially pan-resistant non-fermentative gram negative bacilli is increasing.It is mandatory for hospitals to take effective control measures.更多还原