摘要
目的了解2011年华东地区临床分离菌的分布和耐药特征,指导临床合理使用抗菌药物。方法采用纸片扩散法(K-B法)或自动化仪器法对2011年华东地区14所医院临床分离菌株进行药敏试验,按CLSI 2011年标准判定药敏结果,并用WHONET5.6软件进行数据分析。结果 14所医院共分离细菌40 899株,其中革兰阴性菌28 288株占69.2%,革兰阳性菌12 611株占30.8%,大肠埃希菌和金黄色葡萄球菌分别占据革兰阴性杆菌和革兰阳性球菌的首位;大肠埃希菌、肺炎克雷伯菌和奇异变形菌中产超广谱β-内酰胺酶(ESBLs)的检出率分别为66.7%、43.3%和47.8%,葡萄球菌属中MRSA和MRSCN的检出率分别为50.6%和72.0%;肠杆菌科细菌对碳青霉烯类抗菌药物高度敏感,敏感率均>90.0%,阿米卡星对所有肠杆菌科细菌、头孢吡肟对沙雷菌属和柠檬酸菌属以及奇异变形菌的敏感率均>80.0%;铜绿假单胞菌对碳青霉烯类的耐药率仍<30.0%,除阿米卡星和哌拉西林/他唑巴坦外对各抗菌药物的敏感率均<80.0%,而不动杆菌属除对阿米卡星、米诺环素外,对其他各种抗菌药物敏感率均<50.0%,其中对碳青霉烯类的耐药率达60.0%,粪肠球菌和屎肠球菌而对万古霉素分别有1.6%和3.4%的耐药率。结论华东地区细菌耐药性严重,除产ESBLs大肠埃希菌和肺炎克雷伯菌、MRSA等,应密切关注碳青霉烯类耐药肠杆菌。
OBJECTIVE To investigate the distribution characteristics and drug resistance profile of clinical isolates in east China in 2011 so as to guide the reasonable clinical use of antibiotics.METHODS The drug susceptibility testing of clinical isolates in 14 hospitals from east China was performed using K-B method or automated system.The results were analyzed by WHONET5.6 according to CLSI 2011.RESULTS Of 40 899 strains of pathogens isolated from 14 hospitals,there were 28 288（69.2%） strains of gram-negative bacilli and 12 611（30.8%） strains of gram-positive cocci.Escherichia coli was the most frequently isolated pathogen in the gram-negative bacilli and Staphylococcus aureus was the most common pathogen in the gram-positive cocci,50.6% of Staphylococcus aureus and 72.0% of coagulase-negative Staphylococci were methicillin-resistant.ESBLs were detected in 66.7% of E.coli,43.3% of K.pneumonia and 47.8% of P.mirabilis strains respectively.The detection rates of the MRSA and MRCNS were 50.6% and 72.0%,respectively.The drug susceptibility rate of Enterobacteriaceae to carbapenems was higher than 90.0%,the drug susceptibility rates of Enterobacteriaceae to amikacin and Serratia,Citric acid bacteria,and Proteus spp to cefepime were higher than 80.0%,and the The drug resistance rates of Acinetobacter spp to imipenem and meropenem were 60.0%,and less than 30.0% of P.aeruginosa.The drug resistance rates of E.faecium and E.faecalis strains to vancomycin were 1.6% and 3.4%,respectively.CONCLUSION The drug resistance of the bacteria isolated from east China is serious.Except for the ESBLs-producing E.coli K.pneumoniae,and MRSA,great attention should be paid to the carbapenems-resistant Enterobacter.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第22期4971-4976,共6页
Chinese Journal of Nosocomiology
基金
卫生行业科研专项项目(201002021)
