2011年临床分离菌的分布及耐药性监测

摘要

Objective To survey the distribution and antimicrobial resistance of the pathogens identified during 2011.Methods Antimicrobial susceptibility testing was conducted by Kirby-Bauer method.Data were analyzed according to CLSI 2010 breakpoints with WHONET 5.5 software.Results A total of 4 575 clinical isolates were collected during 2011,of which gram negative bacilli and gram positive cocci accounted for 78％ and 22％ respectively.The most common pathogen was E.coli (21.1％),followed by K.pneumoniae (16.0％),P.aeruginosa (15.6％) and A.baumanii (15.0％).The Enterobacteriaceae isolates showed lower resistance rate to imipenem and meropenem (＜ 2％).About 24.6％ and 20.3％ of P.aeruginosa isolates were resistant to imipenem and meropenem respectively.About 59.3 ％ and 62.8 ％ of A.baumanii isolates were resistant to imipenem and meropenem respectively.Methicillin-resistant strains accounted for an average of 48.2％ in S.aureus and 58.3％ in coagulase-negative Staphylococcus.Staphylococcus isolates were still susceptible to minocycline and chloramphenicol.No staphylococcal strains were found resistant to vancomycin,teicoplanin or linezolid.But a few coagulase-negative staphylococcal strains were found intermediate to teicoplanin.Some strains of Enterococcus were found resistant to vancomycin.The prevalence of vancomycin-resisitant strains was 1.8％ in E.faecalis,and 4.4％ in E.faecium.However,no enterococcal strain was found resistant to teicoplanin or linezolid.Conclusions Antimicrobial resistance surveillance plays an important role in controlling hospital infection.%目的 监测2011年临床分离病原菌的分布及对常用抗菌药物的耐药性.方法 回顾性分析河北医科大学第二医院2011年收集的细菌药敏试验监测数据,采用K-B纸片法药敏试验,按CLSI 2010年版标准判读结果,数据分析采用WHONET5.5软件.结果 2011年共分离细菌4 575株,革兰阴性菌占78％,革兰阳性菌占22％.革兰阴性菌中大肠埃希菌的比率较高,为21.1％,肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌分别占16.0％、15.6％和15.0％；肠杆菌科细菌对亚胺培南和美罗培南耐药率较低,总耐药率＜2％.铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为24.6％和20.3％,鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别为59.3％和62.8％；金葡菌和凝固酶阴性葡萄球菌中对甲氧西林耐药株所占比率分别为48.2％和58.3％.未发现对利奈唑胺、万古霉素和替考拉宁耐药的葡萄球菌属细菌,但是有对替考拉宁中介的凝固酶阴性葡萄球菌.葡萄球菌属细菌对米诺环素和氯霉素保持较低的耐药性.肠球菌中粪肠球菌和屎肠球菌对万古霉素的耐药率分别为1.8％和4.4％,未发现对替考拉宁和利奈唑胺耐药的菌株.结论 细菌耐药性监测能准确掌握细菌对抗菌药物的耐药动向和耐药性变迁,具有指导临床合理用药的重要意义.