摘要
目的分析中南地区2011年临床分离菌的分布特征和对常用抗菌药物的耐药性,为临床用药提供参考依据。方法采用纸片扩散法或自动化仪器法对2011年中南地区6所医院临床分离菌株进行药敏试验,按CLSI2011年标准判定药敏结果,采用WHONET5.6软件进行数据分析。结果中南地区2011年共分离细菌23 985株,其中革兰阴性菌占69.3%,革兰阳性菌占30.7%,前5位病原菌依次为大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、鲍氏不动杆菌、肺炎克雷伯菌,耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRSCN)检出率分别为54.3%和75.6%;肠球菌属对万古霉素、替考拉宁的耐药率均<2.0%,大肠埃希菌、克雷伯菌属和奇异变形菌中产ESBLs株分离率分别为74.8%、54.6%和14.5%,肠杆菌科细菌对碳青霉烯类抗菌药物最为敏感,敏感率为90.3%～100%,铜绿假单胞菌对美罗培南、亚胺培南的的耐药率<30.0%,而鲍氏不动杆菌对碳青霉烯类的耐药率接近50.0%,嗜麦芽寡养单胞菌对头孢他啶、替卡西林/克拉维酸的敏感率最低,<60.0%,对米诺环素、左氧氟沙星的敏感性最高,>80.0%,洋葱伯克菌对美罗培南和米诺环素的敏感率较高,>70.0%,对替卡西林/克拉维酸的敏感率最低为17.1%,流感嗜血菌β-内酰胺酶阳性率为44.8%,除对氨苄西林和磺胺甲噁唑/甲氧苄啶敏感率稍低外,对其他药物的敏感率大部分>70.0%。结论临床常见病原菌仍以革兰阴性杆菌为主,细菌耐药性呈上升趋势,特别是肠杆菌科细菌产ESBLs菌株增高明显,应重视耐万古霉素肠球菌、碳青霉烯类耐药肠杆菌及多药耐药革兰阴性杆菌的流行。
OBJECTIVE To investigate the antibiotics resistance of clinical isolates from central-southern China in 2011 so as to provide evidence for the clinical medication.METHODS The antimicrobial susceptibility testing of the clinical isolates from 6 hospitals in the central-southern China was tested by Kirby-Bauer method or automated system,the results were determined according to CLSI,2011,and the statistical analysis was performed by WHONET5.6.RESULTS A total of 23 985 strains were isolated from 6 hospitals in central-southern China in 2011,with 69.3% of the gram-negative bacilli and 30.7% of the gram-positive cocci.The top five species of pathogens were Escherichia coli,Pseudomonas aeruginosa,Staphylococcus aureus,Acinetobacter baumannii and Klebsiella pneumonia.The detection rates of the MRSA and MRSCN were 54.3% and 75.6%,respectively.Less than 2.0% of the Enterococcus spp were resistant to vancomycin or teicoplanin.The isolation rates of ESBLs-producing E.coli,Klebsiella spp and P.mirabilis were 74.8%,54.6%,and 14.5%,respectively.The drug susceptibility rates of Enterobacteriaceae to carbapenems ranged between 90.3% and 100%.The drug resistance rates of A.baumannii to imipenem and meropenem were about 50.0%,and less than 30.0% of P.aeruginosa.The S.maltaphilia isolates were most susceptible to levofloxacin and minocycline,with the drug susceptibility rates higher than 80.0%,and less than 60.0% to ceftazidime and ticarcillin-clavulanic acid.The drug susceptibility rates of Burkholderia to meropenem and minocycline were higher than 70.0% and was the lowest to ticarcillinclavulanic acid（17.1%）.The isolation rates of β-lactamase-producing H.influenzae was 44.8%,the drug susceptibility rates to all the antibiotics were higher than 70.0% except ampcillin and sulfamethoxazole / trimethoprim.CONCLUSION The gram-negative bacilli remain prevalent in the clinical isolates,and bacterial resistance rate is on the rise.The prevalence of ESBLs-producing Enterobacteriaceae isolates increase significantly.Great attention should be paid to the prevalence of vancomycin-resistant Enterococci,carbapenems-resistant Enterobacteriaceae and multi-drug resistant gram-negative bacilli.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第22期4977-4982,共6页
Chinese Journal of Nosocomiology
基金
卫生行业科研专项项目(201002021)
