摘要
目的 :了解上海地区临床分离菌的耐药情况。方法∶2 0 0 0年 4月至 2 0 0 1年 3月上海 11家医院临床分离菌用Kirby bauer法进行药敏试验。结果∶185 33株细菌中革兰阳性菌占 34 % ,革兰阴性菌占 6 6 %。耐甲氧西林金黄色葡萄球菌 (MR SA)和耐甲氧西林凝固酶阴性葡萄球菌 (MRCNS)分别占金黄色葡萄球菌 (金葡菌 )和凝固酶阴性葡萄球菌的 6 3%与 77% ,无万古霉素耐药株。粪肠球菌耐万古霉素株 6 .9% ,屎肠球菌中为 3.3%。肺炎球菌儿童分离株中耐青霉素株占 30 .9% ,其中 3株高耐株。青霉素中度敏感株 (PISP)与耐青霉素株 (PRSP)对万古霉素和碳青霉烯类均高度敏感。肠杆菌属、枸橼酸杆菌属、克雷伯菌属和普鲁威登菌属对头孢噻肟、头孢曲松和头孢他啶的耐药率分别达 34 %～ 47%、34 %～ 5 6 %和 2 1%～ 41%。各医院分离的大肠埃希菌中产超广谱 β内酰胺酶 (ESBLs)株占 15 .5 %～ 2 1.3%、克雷伯菌属中 2 4.3%～ 5 4.9%。产ESBLs菌株对 19种抗菌药和 5种酶抑制剂复方的耐药率 (除碳青霉烯类外 )均显著高于不产ESBLs株。结论∶细菌耐药性仍是目前临床上的严重问题 ,需要各有关部门共同商讨有效对策。
Objective: To investigate the bacterial resistance of clinical isolates from eleven Shanghai hospitals for the guidance of rational use of antibiotics. Methods:Antimicrobial susceptibility of clinical isolates were tested by Kirby Bauer method.Results:Of 18533 clinical isolates, Gram positive organisms accounted for 34%, Gram negative organisms 66%. MRSA and MRCNS accounted for 63% and 77% of S aureus and coagulase negative staphylococci respectively, no vancomycin resistant strains were found. 6.9% of E fecalis and 3.3% of E fecium were vancomycin resistant strains. 30.9% of S pneumoniae strains from children were penicillin nonsusceptible (PISP+PRSP), and three of them were penicillin resistant (PRSP). However, all the PISP and PRSP strains were susceptible to vancomycin and carbapenems. The resistance rates of Enterbacter spp., Citrobacter spp., Klebsiella spp and Providencia spp to the third generation cephalosporins (cefotaxime, ceftriaxone and ceftazidime) were 34%-47%, 34%-56% and 21%-41% respectively. The ESBLs producing strains accounted for 15.5%-21.3% in E. coli and 24.3%-54.9% in Klebsiella spp of different hospitals. The resistance rates of ESBLs producing strains to 19 antimicrobial agents (except carbapenems) and 5 β lactam/β lactamase inhibitor were much higher than those of ESBLs nonproducing strains.Conclusions: bacterial resistance is still or even a more serious clinical problem than before. An unanimous effective strategy for the control of this problem is urgently needed.
出处
《中国抗感染化疗杂志》
2002年第1期1-9,共9页
Chinese Journal of Infection and Chemotherapy
基金
日本三共制药株式会社
