2011—2012年安徽省立儿童医院细菌耐药性监测
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陈必全

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R969.3

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Surveillance of antimicrobial resistance in Anhui Provincial Children’s Hospital during 2011-2012
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    摘要:

    目的了解2011—2012年安徽省立儿童医院临床分离病原菌对常用抗菌药物的耐药性。方法采用KB纸片扩散法对该院临床分离的病原菌进行药敏试验。结果共检出病原体3 946株,革兰阳性菌、革兰阴性菌、真菌、支原体各占43.92%、37.91%、15.91%、2.26%。居病原体首位的为大肠埃希菌(16.32%),其次为肺炎链球菌(16.02%)、金黄色葡萄球菌(9.00%)、肺炎克雷伯菌(7.40%)等。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(MRCNS)分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的41.41%(147/355)、81.40%(197/242);大肠埃希菌、肺炎克雷伯菌产超广谱β内酰胺酶(ESBLs)率分别为68.17%(439/644)、72.95%(213/292)。肺炎链球菌对红霉素(99.84%)、克林霉素(98.58%)高度耐药;MRSA对克林霉素、红霉素的耐药率较高(>75%),MRSA和MRCNS对万古霉素、替考拉宁和利奈唑胺敏感率均为100.00%;屎肠球菌对万古霉素耐药率为98.31%;鲍曼不动杆菌除对头孢哌酮/舒巴坦耐药率(8.70%)较低,对其他抗菌药物耐药率均较高;铜绿假单胞菌耐药率较低的抗菌药物有亚胺培南、美罗培南、头孢他啶、阿米卡星和环丙沙星(<26%)。检出4株对碳青霉烯类药物耐药的产ESBLs肺炎克雷伯菌,15 株泛耐药鲍曼不动杆菌。结论定期进行细菌耐药性监测,有助于了解医院细菌耐药变迁,为临床经验用药提供依据。

    Abstract:

    ObjectiveTo investigate the resistance of clinical bacterial isolates to commonly used antimicrobial agents in a hospital during 2011-2012.MethodsAntimicrobial susceptibility testing of clinically isolated pathogens was performed by KirbyBauer method.ResultsA total of 3 946 pathogenic isolates were detected, grampositive bacteria, gramnegative bacteria, fungi and mycoplasma accounted for 43.92%, 37.91%, 15.91%, and 2.26% respectively.The top one isolate was Escherichia coli (16.32%), followed by Streptococcus pneumoniae (16.02%), Staphylococcus aureus (9.00%), and Klebsiella pneumoniae (7.40%) and so on. Methicillinresistant Staphylococcus aureus (MRSA) and methicillinresistant coagulasenegative staphylococcus (MRCNS) respectively accounted for 41.41%(147/355)of Staphylococcus aureus and 81.40%(197/242)of coagulasenegative staphylococcus;extendedspectrum βlactamaseproducing rate of Escherichia coli and Klebsiella pneumoniae was 68.17%(439/644) and 72.95%(213/292)respectively. The resistant rate of Streptococcus pneumoniae to erythromycin and clindamycin was 99.84% and 98.58% respectively; the resistance rate of MRSA to clindamycin and erythromycin was higher (>75%),the resistance rates of MRSA and MRCNS to vancomycin, teicoplanin and linezolid were all 100.00%;the resistance rate of Enterococcus faecium to vancomycin was 98.31%;the resistance rate of Acinetobacter baumannii to cefoperazone/sulbactam was low(8.70%), while to the other antimicrobial agents were all high; the resistance rate of Pseudomonas aeruginosa to imipenem, meropenem, ceftazidime,amikacin and ciprofloxacin were all low (<26%). Four carbapenemresistant ESBLproducing Klebsiella pneumoniae isolates and 15 pandrugresistant Acinetobacter baumannii were detected.ConclusionRegular monitor on drug resistance of bacteria helps to understand the changes in bacterial resistance in hospitals, and provide the basis for empirical antimicrobial use.

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陈必全,方庆丰,王胜,等.2011—2012年安徽省立儿童医院细菌耐药性监测[J]. 中国感染控制杂志,2013,12(4):259-262. DOI:10.3969/j. issn.1671-9638.2013.
CHEN Biquan, FANG Qingfeng, WANG Sheng, et al. Surveillance of antimicrobial resistance in Anhui Provincial Children’s Hospital during 2011-2012[J]. Chin J Infect Control, 2013,12(4):259-262. DOI:10.3969/j. issn.1671-9638.2013.

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  • 收稿日期:2012-08-22
  • 最后修改日期:2012-09-12
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  • 在线发布日期: 2013-07-30
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