现代肿瘤医学
現代腫瘤醫學
현대종류의학
JOURNAL OF MODERN ONCOLOGY
2014年
10期
2423-2426
,共4页
恶性肿瘤%多重耐药菌%超广谱β-内酰胺酶%大肠埃希菌
噁性腫瘤%多重耐藥菌%超廣譜β-內酰胺酶%大腸埃希菌
악성종류%다중내약균%초엄보β-내선알매%대장애희균
malignant tumor%multipledrug-resistantstrains%extended spectrum beta-lactamases%Escherichia coli
目的：动态观察我院从2009年到2012年，4年间多重耐药菌的检出率和耐药性。方法：采用美国临床实验室标准化委员会（ NCCLS/CLSI）推荐的纸片扩散确证法检测ESBLs与MRSA。MIC法做药敏试验，利用WHONET5.4分析软件对药敏试验进行统计分析。结果：4年来ESBLs阳性率大肠埃希菌由59.3%升至72.1%；肺炎克雷伯菌由21.2%升至46.7%；奇异变形杆菌阳性率偏低。ESBLs阳性株对碳青霉烯类、阿米卡星和β-内酰胺类/β-内酰胺酶抑剂类的耐药率较低；MRSA阳性率由53.3%降至29.8%；MRCNS阳性率由54.7%升至56.6%，无明显变化。但MRSA呈多重耐药性，对MRSA菌株的治疗首选糖肽类抗菌药物；多重耐药非发酵菌的检出率呈上升趋势。结论：4年来，大肠埃希菌和肺炎克雷伯菌中ESBLs阳性率逐年上升；MRSA阳性率呈现下降趋势，而MRCNS阳性率则变化不大；多重耐药非发酵菌的检出率呈上升趋势。
目的：動態觀察我院從2009年到2012年，4年間多重耐藥菌的檢齣率和耐藥性。方法：採用美國臨床實驗室標準化委員會（ NCCLS/CLSI）推薦的紙片擴散確證法檢測ESBLs與MRSA。MIC法做藥敏試驗，利用WHONET5.4分析軟件對藥敏試驗進行統計分析。結果：4年來ESBLs暘性率大腸埃希菌由59.3%升至72.1%；肺炎剋雷伯菌由21.2%升至46.7%；奇異變形桿菌暘性率偏低。ESBLs暘性株對碳青黴烯類、阿米卡星和β-內酰胺類/β-內酰胺酶抑劑類的耐藥率較低；MRSA暘性率由53.3%降至29.8%；MRCNS暘性率由54.7%升至56.6%，無明顯變化。但MRSA呈多重耐藥性，對MRSA菌株的治療首選糖肽類抗菌藥物；多重耐藥非髮酵菌的檢齣率呈上升趨勢。結論：4年來，大腸埃希菌和肺炎剋雷伯菌中ESBLs暘性率逐年上升；MRSA暘性率呈現下降趨勢，而MRCNS暘性率則變化不大；多重耐藥非髮酵菌的檢齣率呈上升趨勢。
목적：동태관찰아원종2009년도2012년，4년간다중내약균적검출솔화내약성。방법：채용미국림상실험실표준화위원회（ NCCLS/CLSI）추천적지편확산학증법검측ESBLs여MRSA。MIC법주약민시험，이용WHONET5.4분석연건대약민시험진행통계분석。결과：4년래ESBLs양성솔대장애희균유59.3%승지72.1%；폐염극뢰백균유21.2%승지46.7%；기이변형간균양성솔편저。ESBLs양성주대탄청매희류、아미잡성화β-내선알류/β-내선알매억제류적내약솔교저；MRSA양성솔유53.3%강지29.8%；MRCNS양성솔유54.7%승지56.6%，무명현변화。단MRSA정다중내약성，대MRSA균주적치료수선당태류항균약물；다중내약비발효균적검출솔정상승추세。결론：4년래，대장애희균화폐염극뢰백균중ESBLs양성솔축년상승；MRSA양성솔정현하강추세，이MRCNS양성솔칙변화불대；다중내약비발효균적검출솔정상승추세。
Objective:To investigate the detection rate of multiple drug resistant and drug resistance from 2009 to 2012 in our hospital. Methods:ESBLs and MRSA were detected by the method recommended by National Committee for Clinical Laboratory Standards or Clinical and Laboratory Standards Institute. The antibiotic susceptibility was tested by the MIC method and the data were analyzed by the software of WHONET5. 4. Results:The positive rate of Esche-richia coli producing ESBLs was increased from 59. 3% to 72. 1% and Klebsiella producing ESBLs was increased from 21. 2% to 46. 7% in four years. The strains producing ESBLs only to carbapenems,amikacin,β-lactam/β-lactamase depressant drug resistance were low. The positive rate of MRSA was decreased from 53. 3% to 29. 8%. The positive rate of MRCNS was little changed from 54. 7% to 56. 6%. But strains of MRSA showed multiple drug resist-ance and glycopeptide treatment should be the preferred drug. The detection rate of multi-drug resistant non-fer-mentative bacteria was rising. Conclusion:The positive rate of Escherichia coli,Klebsiella pneumoniae producing ES-BLs increased year by year. The positive rate of MRSA was declined. The positive rate of MRCNS was little changed. The detection rate of multi-drug resistant non-fermentative bacteria rise.
