摘要
目的:了解上海地区血培养分离菌的分布及耐药性。方法:对上海地区11所医院2001年1月至2001年12月所有血细菌培养阳性标本按常规方法进行分离、鉴定,用Kirby-Bauer纸片扩散法进行药敏试验。结果:2001年自血标本中共获临床分离菌883株,其中革兰阳性球菌469株,占53.1％,革兰阴性杆菌414株,占46.9％。最常见的5种分离菌依次为凝固酶阴性葡萄球菌(CNS)(38.5％)、大肠埃希菌(12.3％)、克雷伯菌属(7.5％)、金黄色葡萄球菌(金葡菌)(6.6％)和铜绿假单胞菌(5.0％).占血标本分离菌的69.9％。甲氧西林耐药金葡菌(MRSA)和甲氧西林耐药凝固酶阴性葡萄球菌(MRCNS)分别占金葡菌和CNS的50％和76.3％。葡萄球菌属及肠球菌属中均未发现万古霉素耐药菌株。大肠埃希菌及克雷伯菌属中产超广谱β内酰胺酶(ESBLs)菌株检出率分别为19.3％和31.8％。非产ESBLs株对β内酰胺类抗生素(除3种碳青霉烯类外)均远较产ESBLs菌株敏感。非发酵菌中铜绿假单胞菌、不动杆菌属对碳青霉烯类及环丙沙星的耐药率在10％左右。分离到的嗜麦芽窄食单胞菌半数以上对环丙沙星敏感,对其他测试的抗菌药多数耐药。结论:需氧革兰阳性球菌在血流感染中占重要地位,血培养分离株对常用抗菌药耐药现象普遍。
Objective: To investigate the distribution and antimicrobial resistance of blood isolates from eleven hospitals in Shanghai. Methods: The isolates were from blood culture and identified by conventional method from January to December 2001. Susceptibility of these isolates to more than 20 antimicrobial agents were determined by Kirby-Bauer method. Results: A total of 883 strains were isolated from blood specimens, gram-positive cocci and gram-negative bacilli accounted for 53. 1% and 46.9% of these isolates respectively. Coagulase-negative staphylococci (38.5%), Escherichia coli (12.3%), Klebsiella spp. (7.5%), Staphylococcus aureus (6.6%) and Pseudomonas aeruginosa (5.0%) were most frequently isolated, altogether accounted for 69. 9% of all the blood isolates. Methicillin resistance was detected in 50% of S. aureus and 76. 3% of CNS . No strains resistant to vancomycin were found in staphylococci and enterococci. ESBLs were detected in isolates of 19. 3% E. coli and 31. 8% of Klebsiella spp. . Non-ESBL producing strains were much more susceptible to β-lactam antibiotics (except 3 car bapenem antibiotics) than ESBL-producing strains. Ciprofloxacin resistance was detected in strains of 10% P. aeruginosa and Acinetobacter species. More than 50% strains of Stenotrophomonas maltophilia were highly resistant to commonly used antimicrobials tested except ciprofloxacin. Conclusions:Gram-positive cocci are important pathogens in blood stream infections; resistance to commonly used antibiotics is high in these isolates.
出处
《中国抗感染化疗杂志》
2004年第4期193-198,共6页
Chinese Journal of Infection and Chemotherapy
