中国医学创新
中國醫學創新
중국의학창신
MEDICAL INNOVATION OF CHINA
2013年
26期
134-137,138
,共5页
细菌耐药性%抗菌药物%药敏试验
細菌耐藥性%抗菌藥物%藥敏試驗
세균내약성%항균약물%약민시험
Bacterial resistance%Antimicrobial agent%Antimicrobial susceptibility testing
目的：了解山东省济南市中心医院2012年临床分离菌对常见抗菌药物的耐药情况。方法：采用纸片扩散法（K-B法）和E-test法进行药敏试验，采用美国临床和实验室标准协会（CLSI）2012版标准判断结果。结果：临床分离细菌1641株，革兰阳性菌为480株（29.3%），革兰阴性菌为1161株（70.7%）。MRSA和MRSCNS检出率分别为47.0%（133/283）和69.8%（37/53）。未发现对万古霉素、利奈唑胺耐药的葡萄球菌。32株肺炎链球菌中，全部来自非脑脊液标本。仅一株分离自儿童患者的细胞株对青霉素耐药（PRSP），其余均为敏感。肠杆菌科细菌中产ESBLs大肠埃希菌和肺炎克雷伯菌的检出率分别为60.5%和44.7%，仅有两株肺炎克雷伯菌对亚胺培南和美罗培南耐药（1.3%）。铜绿假单胞菌仅对氨曲南、亚胺培南、替卡西林/克拉维酸耐药率超过30%。鲍曼不动杆菌仅对米诺环素（29.5%）、头孢哌酮/舒巴坦（30.3%）的耐药率稍低，对其他抗菌药物耐药率均超过45%。嗜麦芽窄食单胞菌对左氧氟沙星、米诺环素、甲氧苄啶-磺胺甲噁唑耐药率分别为11.4%、1.2%、2.2%。流感嗜血杆菌β内酰胺酶检出率为54.3%。结论：细菌对抗感染药物的耐药现状形势严峻，定期进行细菌耐药性监测有助于了解医院和本地区细菌及其耐药性变迁，为临床经验用药和合理用药提供依据。
目的：瞭解山東省濟南市中心醫院2012年臨床分離菌對常見抗菌藥物的耐藥情況。方法：採用紙片擴散法（K-B法）和E-test法進行藥敏試驗，採用美國臨床和實驗室標準協會（CLSI）2012版標準判斷結果。結果：臨床分離細菌1641株，革蘭暘性菌為480株（29.3%），革蘭陰性菌為1161株（70.7%）。MRSA和MRSCNS檢齣率分彆為47.0%（133/283）和69.8%（37/53）。未髮現對萬古黴素、利奈唑胺耐藥的葡萄毬菌。32株肺炎鏈毬菌中，全部來自非腦脊液標本。僅一株分離自兒童患者的細胞株對青黴素耐藥（PRSP），其餘均為敏感。腸桿菌科細菌中產ESBLs大腸埃希菌和肺炎剋雷伯菌的檢齣率分彆為60.5%和44.7%，僅有兩株肺炎剋雷伯菌對亞胺培南和美囉培南耐藥（1.3%）。銅綠假單胞菌僅對氨麯南、亞胺培南、替卡西林/剋拉維痠耐藥率超過30%。鮑曼不動桿菌僅對米諾環素（29.5%）、頭孢哌酮/舒巴坦（30.3%）的耐藥率稍低，對其他抗菌藥物耐藥率均超過45%。嗜麥芽窄食單胞菌對左氧氟沙星、米諾環素、甲氧芐啶-磺胺甲噁唑耐藥率分彆為11.4%、1.2%、2.2%。流感嗜血桿菌β內酰胺酶檢齣率為54.3%。結論：細菌對抗感染藥物的耐藥現狀形勢嚴峻，定期進行細菌耐藥性鑑測有助于瞭解醫院和本地區細菌及其耐藥性變遷，為臨床經驗用藥和閤理用藥提供依據。
목적：료해산동성제남시중심의원2012년림상분리균대상견항균약물적내약정황。방법：채용지편확산법（K-B법）화E-test법진행약민시험，채용미국림상화실험실표준협회（CLSI）2012판표준판단결과。결과：림상분리세균1641주，혁란양성균위480주（29.3%），혁란음성균위1161주（70.7%）。MRSA화MRSCNS검출솔분별위47.0%（133/283）화69.8%（37/53）。미발현대만고매소、리내서알내약적포도구균。32주폐염련구균중，전부래자비뇌척액표본。부일주분리자인동환자적세포주대청매소내약（PRSP），기여균위민감。장간균과세균중산ESBLs대장애희균화폐염극뢰백균적검출솔분별위60.5%화44.7%，부유량주폐염극뢰백균대아알배남화미라배남내약（1.3%）。동록가단포균부대안곡남、아알배남、체잡서림/극랍유산내약솔초과30%。포만불동간균부대미낙배소（29.5%）、두포고동/서파탄（30.3%）적내약솔초저，대기타항균약물내약솔균초과45%。기맥아착식단포균대좌양불사성、미낙배소、갑양변정-광알갑오서내약솔분별위11.4%、1.2%、2.2%。류감기혈간균β내선알매검출솔위54.3%。결론：세균대항감염약물적내약현상형세엄준，정기진행세균내약성감측유조우료해의원화본지구세균급기내약성변천，위림상경험용약화합리용약제공의거。
Objective:To investigate the resistance of clinical isolate collected from the Jinan Central Hospital in 2012.Method:Antimicrobial susceptibility testing was conducted according to an agreed protocal using Kirby-Bauer(K-B)method.Results were analyzed according to the breakpoints of CLSI 2012.Result:Of the 1641 clinical isolates,gram positive strains and gram negative strains accounted for 29.3%and 70.7%respectively.The prevalence of methicillin-resistant strains was 47.0%in S.aureus(MRSA)and 69.8%in coagulase-negtive Staphylococcus(MRCNS).No staphylococcus strain was found resistant to vancomycin or linezolid.No strains of streptococcus pneumoniae were isolated from meningitis.Only one penicillin-resistant S.pneumoniae(PRSP)was isolated from children.The other isolates were penicillin-susceptible S. pneumoniae(PRSP).ESBLs were produced in 60.5%of the E.coli strains,44.7%of the K.pneumoniae.Enterobacteriaceae strains were still very sensitive to carbapenem antibiotics,except two K.pneumoniae strains were resistant to carbapenem antibiotics.More than 30%P.aeruginosa isolates strains were only resistant to ticarcillin-clavulanate,aztreonam, imipenem.More than 45% Acinetobacter baumannii strains were resistanted to all antimicrobials except minocycline and cefoperazone-sulbactam. Stenotrophomonas maltophilia strains were relatively susceptible to sulfamethoxazole-trimethoprim,minocycline,levofloxacin with lower resistance rate.There were 54.3%H.influenzae which producedβ-lactamase.Conclusion:We are facing a more serious situation of bacterial resistance. Periodic surveillance of bacteria resistance is most important and valuable for antimicrobial therapy.
