摘要
目的了解临床常见病原菌的耐药变化趋势,为临床经验性治疗选择抗菌药物提供依据。方法收集2009年1月-2012年12月临床送检的各类标本分离出的病原菌,采用美国德灵Autoscan4自动细菌鉴定/药敏分析系统对细菌作鉴定和药敏分析,药敏试验判断标准和结果解释参照CLSI标准,使用WHONET 5.4软件对数据进行处理。结果 2009-2012年共分离病原菌8 029株,其中革兰阴性菌5 882株占73.3%,革兰阳性菌2 147株占26.7%;2009-2012年产ESBLs大肠埃希菌检出率分别为47.8%、56.9%、59.5%、55.1%,产ESBLs肺炎克雷伯菌检出率分别为35.4%、41.0%、36.7%、41.8%;MRSA的检出率有逐年上升趋势,分别为34.6%、34.3%、35.3%、40.8%,MRCNS的检出率分别为80.9%、83.9%、84.6%、79.8%;未发现耐万古霉素葡萄球菌和粪肠球菌,屎肠球菌对万古霉素的耐药率为2.0%。结论医院临床检出的病原菌主要以大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌为主,耐药菌株的检出率虽较2012年Mohnarin报告的数据低,但呈逐年上升趋势,特别是鲍氏不动杆菌对亚胺培南的耐药率上升趋势明显,应加以重视。
OBJECTIVE To understand the change trend of drug resistance of common pathogenic bacteria and provide the reference for clinical treatment.METHODS A total of common pathogenic bacteria isolated from various clinical specimens were collected from Jan.2009 to Dec.2012.Autoscan4 automatic microbiological identification system was used to perform bacterial identification and drug susceptibility.The criteria and result explanation of drug susceptibility experiment referred to CLSI standard.The data were analyzed by WHONET5.4software.RESULTS A total of 8029 strains of pathogenic bacteria were isolated from 2009 to 2012,including gram negative bacteria 5882 strains accounting for 73.3%and gram positive bacteria 2147 strains accounting for26.7%;the detection rates of Escherichia coli producing by extended spectrumβ-lactamases（ESBLs）from 2009 to 2012were 47.8%,56.9%,59.5%and 55.1%,and that of Klebsiella pneumoniae producing by ESBLs were35.4%,41.0%,36.7%and 41.8%;the detection of MRSA had an increasing trend year by year with 34.6%,34.3%,35.3% and 40.8% respectively and that of MRCNS were 80.9%,83.9%,84.6% and 79.8%;vancomycin-resistant Staphylococci and Enterococcus faecalis were not found,and the drug resistance rate of E.faecalis to vancomycin was 2.0%.CONCLUSIONIn our hospital,the main pathogenic bacteria clinically detected include E.coli,Pseudomonas aeruginosa,and Staphylococcus aureus.Though detection rate of drug-resistant strains is lower than that in Mohnarin report,but it shows an increasing trend year by year;especially the resistance rate of A.baumanii to impenem increases significantly,which should be paid great attentions.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2014年第19期4762-4764,共3页
Chinese Journal of Nosocomiology
基金
广西壮族自治区科学技术厅基金资助项目(桂科攻1140003A-43)
关键词
抗菌药物
病原菌
耐药性
Antimicrobial drug
Bacterial resistance
Susceptibility test
