摘要
目的了解重庆市主要医院临床分离菌对常用抗菌药物的敏感性和耐药性。方法重庆市34所医院(包括一所儿童医院)临床分离菌采用MIC法及K-B法按统一方案进行细菌药物敏感试验,结果按CLSI 2012年版标准判断。结果 2012年1月至12月共收集重庆市临床分离菌共49636株,其中革兰阳性菌占26.6%,革兰阴性菌占73.4%。金葡菌和凝固酶阴性葡萄球菌中甲氧西林耐药株(MRSA和MRCNS)分别为26.9%和72.2%。葡萄球菌属中甲氧西林耐药株对β-内酰胺类抗生素和其他测试药的耐药率显著高于甲氧西林敏感株,未发现万古霉素和利奈唑胺耐药株。肠球菌属中粪肠球菌对多数测试药物的耐药率低于屎肠球菌,两者中均有少数万古霉素耐药株和利奈唑胺耐药株。非脑膜炎肺炎链球菌PISP和PRSP比例较高,未发现万古霉素耐药株。大肠埃希菌、肺炎克雷伯菌中产ESBLs株分别为59.9%和30.9%。肠杆菌科细菌对碳青霉烯类抗生素仍高度敏感,总耐药率小于1.0%。铜绿假单胞菌对亚胺培南和美罗培南耐药率分别为20.2%和18.2%,鲍曼不动杆菌对两者的耐药率分别为52.1%和48.3%。多重耐药肺炎克雷伯菌和鲍曼不动杆菌增加明显。结论细菌耐药性严重,尤其是多重耐药菌对临床构成严重威胁。合理选用抗菌药,加强感染控制措施是当务之急。
Objective To investigate the susceptibility and resistance of clinical isolates from major hospitals of Chongqing. Methods 34 hospitals were involved in this program. Bacterial susceptibility testing was carried out using MIC and Kirby-Bauer method. Results were analyzed according to CLSI 2012. Results A total of 49,636 clinical isolates were collected from January to December 2012, of which Gram negative organisms and Gram positive organisms accounted for 73.4% and 26.6%, respectively. Methicillin resistant strains in S. aureus （MRSA） and coagulase negative Staphylococcus （MRCNS） accounted for 26.9% and 72.2%, respectively. The resistance rates of MR strains to β-lactams and other antimicrobial agents were much higher than those of MS strains. No staphylococcal strain was resistant to vancomycin or linezolid. The resistance rate of E. faecalis strains to most of the drugs tested was much lower than those ofE. faecium. Some strains orE. faecium and E.faecalis were found resistant to vancomycin and linezolid. Regarding non-meningitis S. pneumoniae strains, the rate of PISP and PRSP were high. Strains of Enterobacteriaceae were highly susceptible to imipenem and meropenem, the overall resistance rates being less than 1.0%. Resistance rates of P aeruginosa to imipenem and meropenem were 20.2% and 18.2%, respectively. The resistance rates of A. baumanii to the two carbapenems were 52.1% and 48.3%, respectively. The prevalence of multi-drug resistant K. pneumoniae and A. baumanii increased markedly. Conclusion Bacterial resistance is on the rise, especially the incidence of multi-drug resistant organisms, which has become a major challenge to medical clinics.
出处
《中国抗生素杂志》
CAS
CSCD
北大核心
2014年第5期338-343,共6页
Chinese Journal of Antibiotics
基金
国家临床重点专科建设项目经费
财社(2010)305号
关键词
细菌耐药性监测
细菌药物敏感试验
多重耐药菌
Bacterial resistance surveillance
Bacterial susceptibility testing
Multi-drug resistant bacteria
