中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2008年
6期
615-622
,共8页
顾俊明%李家泰%王镇山%薛欣
顧俊明%李傢泰%王鎮山%薛訢
고준명%리가태%왕진산%설흔
抗药性,细菌%药物监测%微生物敏感性试验%住院病人
抗藥性,細菌%藥物鑑測%微生物敏感性試驗%住院病人
항약성,세균%약물감측%미생물민감성시험%주원병인
Drug resistance,bacterial%Drug monitoring%Microbial sensitivity tests%lnpatients
目的 监测和探讨我国不同地区的8所医院感染患者中分离细菌的耐药情况.方法 按照设计方案对7所医院从2004年9月1日至2005年8月31 日内分离的1 111株致病菌采用国际标准琼脂稀释法进行体外敏感试验,按照美国临床和实验室标准协会(CLSI)2007年的标准测定MIC,以MIC50和MIC90表示抗菌药物的抗菌活性,并计算出耐药率(R%)、中介率(I%)和敏感率(S%).结果 检测到的耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林表皮葡萄球菌(MRSE)分别为39.3%和74.0%.未发现MRSA或MRSE对万古霉素耐药菌株.耐青霉素肺炎链球菌的总耐药率为33.3%(R%5.6%,1%27.7%).肠球菌91株,耐青霉素粪肠球菌40.8%,而耐青霉素屎肠球菌为100%.尚未发现对万古霉素耐药的肠球菌.分离到644株革兰阴性菌.最常见的细菌依次为;大肠埃希菌、肺炎克雷伯菌、不动杆菌、铜绿假单胞菌和阴沟肠杆菌.在大肠埃希菌和肺炎克雷伯菌中,产超广谱酶菌各占38.6%和26.7%.碳青霉烯类美罗培南、亚胺培南是所测定抗菌药物中对肠杆菌科细菌作用最强的抗牛素.多数革兰阴性杆菌对头孢哌酮/舒巴坦和头孢吡肟有很高敏感率.三代头孢中的头孢他啶对多数革兰阴性杆菌仍有很高敏感率.新喹诺酮类的莫西沙星、左氧沙星对革兰阳性和阴性菌均有很强的广谱抗菌作用.结论 本次监测(2004-2005年)与2002-2003年度监测结果显示,在致病菌的耐药类型和某些菌耐药增长趋势方面基本相似.
目的 鑑測和探討我國不同地區的8所醫院感染患者中分離細菌的耐藥情況.方法 按照設計方案對7所醫院從2004年9月1日至2005年8月31 日內分離的1 111株緻病菌採用國際標準瓊脂稀釋法進行體外敏感試驗,按照美國臨床和實驗室標準協會(CLSI)2007年的標準測定MIC,以MIC50和MIC90錶示抗菌藥物的抗菌活性,併計算齣耐藥率(R%)、中介率(I%)和敏感率(S%).結果 檢測到的耐甲氧西林金黃色葡萄毬菌(MRSA)和耐甲氧西林錶皮葡萄毬菌(MRSE)分彆為39.3%和74.0%.未髮現MRSA或MRSE對萬古黴素耐藥菌株.耐青黴素肺炎鏈毬菌的總耐藥率為33.3%(R%5.6%,1%27.7%).腸毬菌91株,耐青黴素糞腸毬菌40.8%,而耐青黴素屎腸毬菌為100%.尚未髮現對萬古黴素耐藥的腸毬菌.分離到644株革蘭陰性菌.最常見的細菌依次為;大腸埃希菌、肺炎剋雷伯菌、不動桿菌、銅綠假單胞菌和陰溝腸桿菌.在大腸埃希菌和肺炎剋雷伯菌中,產超廣譜酶菌各佔38.6%和26.7%.碳青黴烯類美囉培南、亞胺培南是所測定抗菌藥物中對腸桿菌科細菌作用最彊的抗牛素.多數革蘭陰性桿菌對頭孢哌酮/舒巴坦和頭孢吡肟有很高敏感率.三代頭孢中的頭孢他啶對多數革蘭陰性桿菌仍有很高敏感率.新喹諾酮類的莫西沙星、左氧沙星對革蘭暘性和陰性菌均有很彊的廣譜抗菌作用.結論 本次鑑測(2004-2005年)與2002-2003年度鑑測結果顯示,在緻病菌的耐藥類型和某些菌耐藥增長趨勢方麵基本相似.
목적 감측화탐토아국불동지구적8소의원감염환자중분리세균적내약정황.방법 안조설계방안대7소의원종2004년9월1일지2005년8월31 일내분리적1 111주치병균채용국제표준경지희석법진행체외민감시험,안조미국림상화실험실표준협회(CLSI)2007년적표준측정MIC,이MIC50화MIC90표시항균약물적항균활성,병계산출내약솔(R%)、중개솔(I%)화민감솔(S%).결과 검측도적내갑양서림금황색포도구균(MRSA)화내갑양서림표피포도구균(MRSE)분별위39.3%화74.0%.미발현MRSA혹MRSE대만고매소내약균주.내청매소폐염련구균적총내약솔위33.3%(R%5.6%,1%27.7%).장구균91주,내청매소분장구균40.8%,이내청매소시장구균위100%.상미발현대만고매소내약적장구균.분리도644주혁란음성균.최상견적세균의차위;대장애희균、폐염극뢰백균、불동간균、동록가단포균화음구장간균.재대장애희균화폐염극뢰백균중,산초엄보매균각점38.6%화26.7%.탄청매희류미라배남、아알배남시소측정항균약물중대장간균과세균작용최강적항우소.다수혁란음성간균대두포고동/서파탄화두포필우유흔고민감솔.삼대두포중적두포타정대다수혁란음성간균잉유흔고민감솔.신규낙동류적막서사성、좌양사성대혁란양성화음성균균유흔강적엄보항균작용.결론 본차감측(2004-2005년)여2002-2003년도감측결과현시,재치병균적내약류형화모사균내약증장추세방면기본상사.
Objective To determine the drug-resistance rates of bacteria isolated from 7 hospitals located at different areas of China.Methods 1 111 pathogenic strains were isolated for susceptibility test using agar dilution method from Sep 1,204 to Aug 3 1,2005.According to the criteria of guideline of CLSI (2007),MIC50 and MIC90 were detected for antibacterial activity of antimicrobial agents and resistant rate (R%),intermediate rate(I%)and sensitive rate(S%)were calculated based on susceptibility tests.Results The detectable rates of methiciltin-resistant Staphylococcus anreus(MRSA)and methicilllin- resistant Staphylococcus epidermidis(MRSE)were 39.3%and 74.0% respectively.The total resistant rate of penicillin resistant Streptococcus pneumoniae(R%+I%) was 33.3%(R%=5.6%,I%=27.7%). 91 strains of Enterococcus were isolated.The resistant rate of penicillin resistant E.faecalis Was 40.8%.and E.faecium Was 100%.Neither strains of S.aureus nor strains of S.epidemidis were found resistant to vancomycin.No strains of Enterococcus were found resistant to vancomycin.644 strains of gram-negative bacilli were isolated.The most common gram-negative bacilli were E.coli,k pneumoniae,Acinetobacter spp,P.aeruginosa,and E.cloacae,respectively.The ESBLs-producing strains accounted for 38.6% and 26.7% in E.coli and K. pneumoniae.respectively.Meropenem and imipenem were the most potent antimicrobial agents.Cefoperazone/sulbactam demonstrated excellent activity agent of gram-negative bacilli.Most of the gram-negative bacillus still susceptible to ceftazidime.The new fluroquinotones, moxifloxacin and levofloxacin showed strong and broad spectrum activity against the most gram-positive and gram-negative bacteria.Conclusions This surveillance in 2004-2005 together with the surveillance in 2002-2003,were similar in the bacterial resistance pattern and the trend of rising resistant rates for some pathogens.
