2007年细菌耐药监测结果分析

Analysis on antimicrobial resistance surveillance results in 2007

摘要:

目的总结和分析某医院2007年细菌耐药监测资料。方法采用API系统鉴定细菌到种，以纸片扩散法进行药敏试验（按照美国临床实验室标准化研究所2007年标准），药敏结果以WHONET5.4软件进行统计分析。结果全年共分离3 107株细菌，革兰阴性菌占60.93％，革兰阳性菌占27.78％，真菌占11.30％。耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的60.58％和77.35%。屎肠球菌的分离数和耐药率均高于粪肠球菌（P<0.05），氨基糖苷类高度耐药肠球菌的产生率为59.44%。大肠埃希菌和克雷伯菌属超广谱β内酰胺酶产生率分别为59.50％和55.98%。63.97%的铜绿假单胞菌来源于痰标本，不同科室痰标本中分离的铜绿假单胞菌耐药率从高到低依次为重症监护室（21.05%）、神经外科（15.99%）、呼吸急救儿科（7.09%）、呼吸内科（6.07%）。结论定期总结医院细菌耐药监测结果，发现细菌呈多重耐药趋势，对规范医生合理使用抗菌药物具有重大意义。

Abstract:

ObjectiveTo analyze the  data of antimicrobial resistance surveillance in a  hospital in 2007. MethodsBacterial isolates were identified by API system, antimicrobial  susceptibility  tests were performed by KirbyBauer method and  analyzed by WHONET5．4 software. ResultsA total of  3 107 clinical isolates were isolated in 2007，60.93% were gramnegative bacteria,27.78% were grampositive bacteria and 11.30％ were fungi. 60.58％of Staphylococcus aureus was methicillinresistant Staphylococcus aureus  (MRSA) and 77.35% of coagulase negative Staphylococcus was methicillinresistant coagulase negative Staphylococcus (MRCNS) respectively. The prevalence and drugresistance of Enterococcus faecium were higher than Enterococcus faecali (P<0.05), the prevalence of highlevel aminoglycosidesresistant Enterococcus was 59.44%. The prevalence of extendedspectrum  betalactamase of Escherichia coli and Klebsilla spp. was 59.50％and 55.98%, respectively. 63.97% of Pseudomonas aeruginosa were isolated from sputum, drugresistant rate  of Pseudomonas aeruginosa in sputum from patients in ICU, neurosurgical department, respiratory and emergency pediatric department, respiratory department was 21.05%, 15.99%,7.09% and 6.07% respectively .ConclusionPeriodical summarization of   antimicrobial resistance surveillance results  and  discovery of   drugresistance trends is great significant for guiding rational antimicrobial therapy.