安徽省铜陵地区2013年细菌耐药性监测

摘要

Objective To investigate the bacterial resistance profile of clinical isolates collected in Tongling area . Methods Antimicrobial susceptibility test was conducted by Kirby‐Bauer method . All the data were analyzed with WHONET 5 .6 software .Results A total of 3 419 clinical isolates were collected during 2013 ,of which gram negative organisms and gram positive organisms accounted for 75 .9% and 24 .1% .MRSA accounted for 41 .3% of S .aureus and MRCNS accounted for 73 .5% of coagulase negative Staphylococcus ,respectively .MRSA showed higher resistance to gentamicin ,ciprofloxacin , erythromycin and rifampicin . No vancomycin‐ or teicoplanin‐resistant strains of Staphylococcus spp . were found . No vancomycin‐or teicoplanin‐resistant strains of E . f aecalis and E . f aecium were found .About 51 .6% of E .coli isolates and 42 .8% of K . pneumoniae isolates produced extended‐spectrum β‐lactamases (ESBLs ) . The prevalence of imipenem‐ or meropenem‐resistant strains of K . pneumoniae increased significantly .The percentage of P . aeruginosa strains resistant to amikacin ,piperacillin‐tazobactam ,ciprofloxacin ,cefepime and cefoperazone‐sulbactam was lower than 20 .0% .The percentage of A .baumannii strains resistant to cefoperazone‐sulbactam , minocycline and amikacin w as 34 .7% ,57 .0% and 58 .3% , respectively . More than 68 .0 % of A . baumannii strains were resistant to any of the other antibiotics tested . Conclusions The antibiotic resistance is growing in clinical bacterial isolates .The spread of carbapenem‐resistant strains of K . pneumoniae in some departments poses a serious threat to clinical practice .We should pay more attention to resistance surveillance and rational use of antibiotics .%目的：了解安徽省铜陵地区临床分离菌耐药状况。方法用Kirby‐Bauer法进行药敏试验，用WHONET5．6软件进行耐药性分析。结果2013年共收集非重复临床分离菌3419株，其中革兰阴性菌占75．9％，革兰阳性菌占24．1％。耐甲氧西林金黄色葡萄球菌（金葡菌）（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）分别占金葡菌和凝固酶阴性葡萄球菌的41．3％和73．5％；M RSA对红霉素、庆大霉素、环丙沙星和利福平等均高度耐药，未见耐万古霉素和替考拉宁葡萄球菌和肠球菌属。大肠埃希菌和肺炎克雷伯菌中产超广谱β内酰胺酶株分别占51．6％和42．8％，对碳青霉烯类耐药的肺炎克雷伯菌检出率较2012年显著升高。铜绿假单胞菌对阿米卡星、哌拉西林‐他唑巴坦、头孢吡肟、环丙沙星和头孢哌酮‐舒巴坦的耐药率均低于20．0％。鲍曼不动杆菌对头孢哌酮‐舒巴坦、米诺环素和阿米卡星的耐药率分别为34．7％、57．0％和58．3％，对其他抗菌药物耐药率均在68．0％以上。结论细菌耐药性仍呈增长趋势，对碳青霉烯类耐药的肺炎克雷伯菌等广泛耐药菌在某些科室内的流行播散对临床构成严重威胁，因此加强医院感染控制，合理使用抗菌药物显得尤为重要。