CAJ | 학술논문

目的：监测2012年河北省细菌耐药性监测网（hebei antibacterial resistance investigation net，Hebarin）各成员单位临床分离细菌的菌种分布及对常用抗菌药物的耐药性谱型。方法回顾性分析河北省2012年收集细菌药敏试验监测数据，采用K-B纸片法或微量肉汤稀释法药敏试验，判断标准按 CLSI 2010年版，数据分析采用 WHONET 5.5软件。结果2012年共收集细菌10504株，其中革兰阴性菌8003株，占76.2％；革兰阳性菌2501株，占23.8％。革兰阴性杆菌中前五位的细菌分别为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌和阴沟肠杆菌；革兰阳性球菌中前五位的细菌分别为金黄色葡萄球菌、屎肠球菌、粪肠球菌、肺炎链球菌和表皮葡萄球菌。大肠埃希菌和肺炎克雷伯菌中 ESBL的检出率分别为66.5％和46.7％；大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌中对亚胺培南的耐药率分别为0.1％，0.5％和8.9％，对美罗培南的耐药率分别为0.1％，0.6％和4.2％。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为38.9％和32.3％，而鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别为56.5％和59.7％。金黄色葡萄球菌和凝固酶阴性葡萄球菌中甲氧西林耐药株所占比率为57.5％和87.3％。未发现对利奈唑胺、万古霉素耐药的葡萄球菌属细菌，但是出现对替考拉宁耐药的凝固酶阴性葡萄球菌。结论细菌耐药性监测对准确掌握细菌对抗菌药物的耐药动向和耐药性变迁，指导临床合理用药具有重要的意义。
목적：감측2012년하북성세균내약성감측망（hebei antibacterial resistance investigation net，Hebarin）각성원단위림상분리세균적균충분포급대상용항균약물적내약성보형。방법회고성분석하북성2012년수집세균약민시험감측수거，채용K-B지편법혹미량육탕희석법약민시험，판단표준안 CLSI 2010년판，수거분석채용 WHONET 5.5연건。결과2012년공수집세균10504주，기중혁란음성균8003주，점76.2％；혁란양성균2501주，점23.8％。혁란음성간균중전오위적세균분별위대장애희균、폐염극뢰백균、동록가단포균、포만불동간균화음구장간균；혁란양성구균중전오위적세균분별위금황색포도구균、시장구균、분장구균、폐염련구균화표피포도구균。대장애희균화폐염극뢰백균중 ESBL적검출솔분별위66.5％화46.7％；대장애희균、폐염극뢰백균화음구장간균중대아알배남적내약솔분별위0.1％，0.5％화8.9％，대미라배남적내약솔분별위0.1％，0.6％화4.2％。동록가단포균대아알배남화미라배남적내약솔분별위38.9％화32.3％，이포만불동간균대아알배남화미라배남적내약솔분별위56.5％화59.7％。금황색포도구균화응고매음성포도구균중갑양서림내약주소점비솔위57.5％화87.3％。미발현대리내서알、만고매소내약적포도구균속세균，단시출현대체고랍저내약적응고매음성포도구균。결론세균내약성감측대준학장악세균대항균약물적내약동향화내약성변천，지도림상합리용약구유중요적의의。
Objective To investigate antimicrobial resistance and pathogen in hebei antibacterial resistance investigation net in 2012.Methods Antimicrobial susceptibility test was detected by Kirby-Bauer method or broth dilution test.Results were analyzed according to CLSI 2010 breakpoints.WHONET 5.5 software was used to analyze the data.Results A total of 10 504 clinical isolates were collected in 2012,of which gram negative bacilli and gram positive cocci accounted for 76.2%, 23.8%,respectively.The most common pathogen in gram-negative rod was E.coli,K.pneumoniae,P.aeruginosa, A.baumanii and E.cloacae respectively.The most common pathogen in gram-positive cocci was S.aureus,E.facium,E-.faecalis,S.pneumoniae and S.epidermidis.ESBL rate of E.coli and K.pneumoniae was 66.5 and 46.7%.The resistant rate of E.coli,K.pneumoniae,E.cloacae to imipenem was 0.1%,0.5%,8.9% and to meropenem was 0.1%,0.6%,4.2%, respectively.P.aeruginosa was resistant to imipenem and meropenem were 38.9% and 32.3%.A.baumanii was resistant to imipenem and meropenem were 5 6.5% and 5 9.7%.Methicillin-resistant strains accounted for an average of 5 7.5% in S.aureus and 87.3% in coagulase negative staphylococcus.Staphylococcus was still susceptible to minocycline and chloram-phenicol.No staphylococcal strains were found resistant to vancomycin,linezolid.But a few coagulase negative staphylococcal strains were resistant to teicoplanin.Conclusion Surveillance of antimicrobial agents played an important role in controlling hospital infection.