2014年我院临床分离细菌分布及耐药性监测

2014年我院临床分离细菌分布及耐药性监测

摘要】目的：了解我院临床分离病原菌的分布特点及其对常用抗菌药物的敏感

性和耐药性情况。方法：细菌分离按常规方法进行，抗菌药物敏感试验按

CLSI2012年版进行并判断结果。结果：5231株临床分离菌中：革兰阳性菌1236株，占23.6%（1236/5231），革兰阴性菌2147株，占41.0%（2147/5231）。革

兰阳性菌中，金黄色葡萄球菌为分离菌株的第一位。葡萄球菌属细菌中耐甲氧西

林金葡菌（MRSA）和耐甲氧西林CNS（MRCNS）检出率分别为11.6%和39.5%，

万古霉素对革兰阳性球菌的抗菌活性最强，未发现万古霉素中介金葡菌（VISA）

和耐万古霉素金葡菌VRSA菌株。屎肠球菌对测试药物的耐药率普遍高于粪肠球菌，未发现对利奈唑胺、替加环素耐药株。革兰阴性菌中，大肠埃希菌位居第1

位（占32.1%），肺炎克雷伯菌位居第2位（占17.3%）。厄他培南对革兰阴性

肠杆菌的抗菌活性最强，其次是亚胺培南。铜绿假单胞菌对氨苄西林、氨苄西林/舒巴坦、头孢替坦、呋喃妥因、头孢唑啉、头孢呋辛、头孢呋辛酯、头孢曲松的

耐药率在97%以上，呈现多重耐药。鲍曼不动杆菌对头孢哌酮/舒巴坦和阿米卡星的耐药率分别是3.7%和8.3%低于亚胺培南耐药率30.8%，对呋喃妥因、头孢唑啉、头孢曲松的耐药率100%，并呈现广泛耐药株。结论：微生物检验为临床提供可

靠用药依据，合理选用抗菌药物是治疗和预防细菌耐药的关键。

【关键词】耐药性；细菌；细菌耐药性监测；细菌药物敏感性试验

【中图分类号】R446 【文献标识码】A 【文章编号】2095-1752（2015）11-0387-04

Distribution and antibiotic resistance of bacterial pathogens isolated during the period 2012 in our hospital Jiang xiuquan,Liu Xiaojun, Lin Yanqing, You Qinxiu, Guo Linlin. The Second Hospital of Longyan ,Fujian Province, Longyan 364000, China 【Abstract】Objective To investigate the distribution and antibiotic resistance of bacterial pathogens isolated during the period 2014 in our hospital. Methods Clinical isolates were identified and subjected to antimicrobial susceptibility testing by means

of a unified protocol. The results were analyzed according to CLSI breakpoints(2012). Results Of the 5231 clinical isolates, gram positive and gram negative organisms accounted for 23.6% (1236/5231 )and 41.0%(2147/5231), respectively. Coagulase negative Staphylococcus (VISA)was the most frequently isolated gram positive bacteria. The prevalence of methicilin-resisitant strains was 11.6% in Staphylococcus

aureus(MRSA),and 39.5% in coagulase-negative Staphylococcus(MRCNS).Vancomycin was the most active antimicrobial agent against gram positive cocci. No BISA or VRSA strain was identified. E. faecium strains are more resistant to most of the antibiotics tested than E. faecalis. No strain was resistant to linezolid or tigecycline. Escherichia coli were the most frequently isolated gram negative bacteria in our hospital, accounting for 32.1%, followed by Klebsiella strains. Ertapenem was the most active antibacterial agent agent tested against gram negative bacilli. About 3.7%and 8.3% of the A. baumannii strains were resistant to cefoperazone or shubatan and

amikacin,respectively in our hospital,lower than imipenem 30.8%. P. aeruginosa showed relatively lower resistance to ceftazidime, amikacin and ciprofloxacin. More than 97% of these P. aeruginosa strains were resistant to other antibiotics. Conclusions The microbial test provide reliable scientific evidence for clinical medication, which should be paid more attention in clinical and laboratory practice. Rational antimicrobial therapy is a key for control of antimicrobial resistance.